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Chauncy Montgomery
Respite Care in Vidalia, Georgia
NPI 1790094241

Chauncy Montgomery is a Respite Care based in Vidalia, GA. Chauncy Montgomery practices in Vidalia, GA. The NPI Number for Chauncy Montgomery is 1790094241 and holds a License No. (Georgia).

The current practice location address for Chauncy Montgomery is 1114 Jr Rollins Rd, Vidalia, GA and can be reached out via phone at 912-537-4143 and via fax at 912-537-4143.

Location: 1114 Jr Rollins Rd, Vidalia, GA, 30474-9462
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790094241
Provider Name
Chauncy Montgomery
Credential
Provider Entity Type
Organization
Address
1114 Jr Rollins Rd, Vidalia, GA, 30474-9462
Phone Number
912-537-4143
Fax Number
912-537-4143
Provider Enumeration Date
10/01/2010
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
1114 Jr Rollins Rd
City
Vidalia
State
Georgia
Zip
30474-9462
Phone Number
912-537-4143
Fax Number
912-537-4143
person
Provider Business Mailing Address Details
Address
1114 Jr Rollins Rd
City
Vidalia
State
Georgia
Zip
30474-9462
Phone Number
912-537-4143
Fax Number
912-537-4143
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.
(Georgia)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
person
Provider's Taxonomy Details 2
Type
Respite Care Facility
Classification
Respite Care
Speciality
-
Taxonomy
385H00000X
License No.
(Georgia)
Definition
Definition to come.
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