# SUMMERFIELD PERSONAL CARE HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083469092
- **Authorized official:** BRENDA SNOW JACOBS (ADMINISTRATOR/PROVIDER)
- **Authorized official phone:** (678) 600-6704

## Contact information

- **Practice address:** 12166 HIGHWAY 212, COVINGTON, GA 30014-7876
- **Practice address phone:** (678) 600-6704
- **Practice address fax:** (404) 745-8410
- **Mailing address:** 12166 HIGHWAY 212, COVINGTON, GA 30014-7876
- **Mailing address phone:** (678) 600-6704
- **Mailing address fax:** (404) 745-8410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/22/2024
- **Last updated:** 08/04/2024