# CARING HANDS ASSISTED LIVING, LLC.

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

## Provider details

- **NPI number:** 1316217045
- **Authorized official:** MRS. MATHILDA PREVOST (ADMINISTRATOR)
- **Authorized official phone:** (678) 886-6877

## Contact information

- **Practice address:** 1741 HIGHWAY 138 SW, RIVERDALE, GA 30296-1921
- **Practice address phone:** (770) 996-5552
- **Practice address fax:** (770) 996-5552
- **Mailing address:** 1741 HIGHWAY 138 SW, RIVERDALE, GA 30296-1921
- **Mailing address phone:** (770) 996-5552
- **Mailing address fax:** (770) 996-5552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385H00000X | Respite Care | 031012331 | GA | Yes |

## Other

- **Enumeration date:** 01/11/2012
- **Last updated:** 01/11/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 911309871 | CCSP PROVIDER | GA |