SID'S PLACE INCORPORATED
Residential Treatment Facilities at Luke Dr, Ellenwood, GA

License number
Georgia 031012928
Category
Nursing
Type
Assisted Living Facility
License number
Georgia 031012928
Category
Residential Treatment Facilities
Type
Community Based Residential Treatment Facility, Mental Illness
Owner
Name: MR. ZANNIE DARRELL BLACK
Title: OWNER
Phone: (678) 557-8969
Address
Address
2742 Luke Dr, Ellenwood, GA 30294
National Provider ID: 1174823595
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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