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Andrea Streeter
Intellectual Disabilities Intermediate Care Facility in Stone Mountain, Georgia
NPI 1205205473

Andrea Streeter is a Intellectual Disabilities Intermediate Care Facility based in Stone Mountain, GA. Andrea Streeter practices in Stone Mountain, GA. The NPI Number for Andrea Streeter is 1205205473 and holds a License No. 044016471 (Georgia).

The current practice location address for Andrea Streeter is 439 Watson Bay, Stone Mountain, GA and can be reached out via phone at 770-465-6858.

Location: 439 Watson Bay, Stone Mountain, GA, 30087-6195
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205205473
Provider Name
Andrea Streeter
Credential
Provider Entity Type
Individual
Gender
Female
Address
439 Watson Bay, Stone Mountain, GA, 30087-6195
Phone Number
770-465-6858
Fax Number
Provider Enumeration Date
09/17/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
439 Watson Bay
City
Stone Mountain
State
Georgia
Zip
30087-6195
Phone Number
770-465-6858
Fax Number
person
Provider Business Mailing Address Details
Address
439 Watson Bay
City
Stone Mountain
State
Georgia
Zip
30087-6195
Phone Number
770-465-6858
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
044016471 (Georgia)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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