Provider Demographics
NPI:1356583751
Name:THE ARMOUR HOUSE II
Entity type:Organization
Organization Name:THE ARMOUR HOUSE II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:THORNTON
Authorized Official - Last Name:ARMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-274-3358
Mailing Address - Street 1:209 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RAYLE
Mailing Address - State:GA
Mailing Address - Zip Code:30660-1104
Mailing Address - Country:US
Mailing Address - Phone:706-274-3358
Mailing Address - Fax:706-743-7477
Practice Address - Street 1:209 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:RAYLE
Practice Address - State:GA
Practice Address - Zip Code:30660-1104
Practice Address - Country:US
Practice Address - Phone:706-274-3358
Practice Address - Fax:706-743-7477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA516055471BMedicaid