SHIRLEY HOME AWAY FROM HOME

NPI # 

Practice Address:

190 Middling Ln

Fayetteville, GA, 30214-3767

Practice Phone:

678-557-2207

License Number:

056-01-011-1

License State:

GA

Taxonomy Grouping:

Residential Treatment Facilities

Taxonomy Classification:

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Taxonomy Code:

320900000X