Provider Demographics
NPI:1497473904
Name:HALO GROUP OF MIDDLE GEORGIA, INC.
Entity Type:Organization
Organization Name:HALO GROUP OF MIDDLE GEORGIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-955-8119
Mailing Address - Street 1:PO BOX 1078
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-1078
Mailing Address - Country:US
Mailing Address - Phone:478-224-4866
Mailing Address - Fax:
Practice Address - Street 1:900 BALL ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-3459
Practice Address - Country:US
Practice Address - Phone:478-224-4866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services