# A PLACE LIKE HOME RESPITE CARE SERVICES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1104693225
- **Authorized official:** GREGORY A WILKERSON JR. AGACNP-BC (PROVIDER/OWNER)
- **Authorized official phone:** (678) 468-8672

## Contact information

- **Practice address:** 1269 NATHAN MAULDIN DR, LAWRENCEVILLE, GA 30043-7249
- **Practice address phone:** (470) 263-2806
- **Practice address fax:** (802) 365-8491
- **Mailing address:** 1269 NATHAN MAULDIN DR, LAWRENCEVILLE, GA 30043-7249
- **Mailing address phone:** (470) 263-2806
- **Mailing address fax:** (802) 365-8491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2023
- **Last updated:** 12/08/2023