Provider Demographics
NPI:1548650690
Name:REFUGE FAMILY CARE
Entity type:Organization
Organization Name:REFUGE FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAYNOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, MBA
Authorized Official - Phone:678-255-5990
Mailing Address - Street 1:11898 QUAIL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-6294
Mailing Address - Country:US
Mailing Address - Phone:678-255-5990
Mailing Address - Fax:
Practice Address - Street 1:11898 QUAIL RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-6294
Practice Address - Country:US
Practice Address - Phone:678-255-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities