| NPI | 1346473246 |
|---|---|
| Doing Business As | MILDRED'S HOMEPLACE III |
| Entity Type | Organization |
| Authorized Contact | NANCY LEE MITCHELL Administrator 229-228-1985 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 136-01-096-1) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: GA 136-01-096-1) |
| 347C00000X Private Vehicle (Licence: GA 136-01-096-1) | |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |