# BETH'EL PERSONAL CARE HOME

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

## Provider details

- **NPI number:** 1104118108
- **Authorized official:** MS. ABOSEDE ADETUTU OSHINUBI RD, LD (DIRECTOR)
- **Authorized official phone:** (770) 736-6439

## Contact information

- **Practice address:** 4327 WEBB MEADOWS DR, LOGANVILLE, GA 30052-7579
- **Practice address phone:** (770) 736-6439
- **Practice address fax:** (678) 609-5540
- **Mailing address:** 4327 WEBB MEADOWS DR, LOGANVILLE, GA 30052-7579
- **Mailing address phone:** (770) 736-6439
- **Mailing address fax:** (678) 609-5540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | 756428113A | GA | Yes |

## Other

- **Enumeration date:** 05/09/2011
- **Last updated:** 05/09/2011