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Mental Retardation Waiver Program
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Columbus, Georgia
NPI 1740475805

Mental Retardation Waiver Program is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Columbus, GA. Mental Retardation Waiver Program practices in Columbus, GA. The NPI Number for Mental Retardation Waiver Program is 1740475805 and holds a License No. (Georgia).

The current practice location address for Mental Retardation Waiver Program is 2100 Comer Ave, Columbus, GA and can be reached out via phone at 706-596-5583 and via fax at 706-596-5589.

Location: 2100 Comer Ave, Columbus, GA, 31904-8725
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740475805
Provider Name
Mental Retardation Waiver Program
Credential
Provider Entity Type
Organization
Address
2100 Comer Ave, Columbus, GA, 31904-8725
Phone Number
706-596-5583
Fax Number
706-596-5589
Provider Enumeration Date
09/12/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2100 Comer Ave
City
Columbus
State
Georgia
Zip
31904-8725
Phone Number
706-596-5583
Fax Number
706-596-5589
person
Provider Business Mailing Address Details
Address
2100 Comer Ave
City
Columbus
State
Georgia
Zip
31904-8725
Phone Number
706-596-5583
Fax Number
706-596-5589
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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