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Organization
ANTOINETTE FULLER
Active
Organization
ANTOINETTE FULLER
Active
Other names
Place Call Home Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANTOINETTE FULLER OWNER (OWNER OPERATOR)
(678) 519-0131
Entity
Organization
Contact information
Practice address
2024 REGISTRY DR, HAMPTON, GA 30228-6396
(678) 519-0131
Mailing address
2024 REGISTRY DR, HAMPTON, GA 30228-6396
(678) 519-0131
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
GA
311500000X
Alzheimer Center (Dementia Center)
—
GA
311ZA0620X
Adult Care Home Facility
—
GA
315D00000X
Inpatient Hospice
—
GA
Other
Enumeration date
11/17/2009
Last updated
07/21/2022
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