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Organization
MINERS CREEK PERSONAL CARE HOME
Active
Organization
MINERS CREEK PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA MAE THOMPSON (OWNER ADMINISTRATOR)
(404) 641-6275
Entity
Organization
Contact information
Practice address
4227 MINERS CREEK RD, LITHONIA, GA 30038-3814
(404) 641-6275
Mailing address
5506 STONELEIGH CT, STONE MOUNTAIN, GA 30088-3433
(404) 641-6275
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
044017069
GA
Other
Enumeration date
05/04/2008
Last updated
05/04/2008
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