11D1087581 CLIA NUMBER - WEST CARE GEORGIA

Laboratory Demographics

CLIA Number: 11D1087581

Facility Name: WEST CARE GEORGIA

Facility Address:
827 PRYOR STREET
ATLANTA, GA
ZIP 30315
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Facility Phone Number: 404 761-7485

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1194942649

Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	11D1087581
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	WEST CARE GEORGIA
Street	827 PRYOR STREET
City	ATLANTA
State	GA
ZIP	30315
Phone	404 761-7485
CertificateType	4
CertificateEffectiveDate	8/7/2022
CertificateExpirationDate	8/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024