# BRYANA PERSONAL CARE HOME, INC.

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

## Provider details

- **NPI number:** 1457783789
- **Authorized official:** DIANE CHARLES (CEO)
- **Authorized official phone:** (404) 454-7155

## Contact information

- **Practice address:** 6276 FIELD GLEN RD, STONE MOUNTAIN, GA 30087-4911
- **Practice address phone:** (678) 587-5543
- **Practice address fax:** (678) 587-5543
- **Mailing address:** 6276 FIELD GLEN RD, STONE MOUNTAIN, GA 30087-4911
- **Mailing address phone:** (678) 587-5543
- **Mailing address fax:** (678) 587-5543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 044-01-357-2 | GA | Yes |

## Other

- **Enumeration date:** 08/09/2013
- **Last updated:** 08/09/2013