Provider Demographics
NPI:1093830143
Name:DAY RETREAT INC.
Entity Type:Organization
Organization Name:DAY RETREAT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SZCZEPANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-379-2318
Mailing Address - Street 1:5093 FORTENBERRY RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-7005
Mailing Address - Country:US
Mailing Address - Phone:706-379-2318
Mailing Address - Fax:706-379-1417
Practice Address - Street 1:1650 GREENBRIAR DR.
Practice Address - Street 2:UNIT B
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512
Practice Address - Country:US
Practice Address - Phone:706-379-2318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services