# DEPARTMENT OF VETERANS AFFAIR

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

## Provider details

- **NPI number:** 1558548693
- **Authorized official:** MS. ROSULA CRUZ-LAPORTE BSN,RN (STAFF NURSE)
- **Authorized official phone:** (404) 321-6111

## Contact information

- **Practice address:** 1670 CLAIRMONT RD, DECATUR, GA 30033-4004
- **Practice address phone:** (404) 321-6111
- **Practice address fax:** (404) 728-7746
- **Mailing address:** 3492 SKYLAND RIDGE CT, LOGANVILLE, GA 30052-8783
- **Mailing address phone:** (404) 321-6111
- **Mailing address fax:** (404) 728-7746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 011861 | PR | Yes |

## Other

- **Enumeration date:** 01/30/2008
- **Last updated:** 01/30/2008