Provider Demographics
NPI:1932590171
Name:APPLING, JUANITA
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:
Last Name:APPLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2857 SALLYWHITE RD
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-6903
Mailing Address - Country:US
Mailing Address - Phone:706-825-6482
Mailing Address - Fax:706-595-5970
Practice Address - Street 1:2857 SALLYWHITE RD
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-6903
Practice Address - Country:US
Practice Address - Phone:706-825-6482
Practice Address - Fax:706-595-5970
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities