# JASIAH'S PERSONAL CARE HOME

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

## Provider details

- **NPI number:** 1619229416
- **Authorized official:** MS. ANDREA EVANS (CEO)
- **Authorized official phone:** (678) 638-9444

## Contact information

- **Practice address:** 2323 CRIMSON CREEK LN, SNELLVILLE, GA 30078-5047
- **Practice address phone:** (678) 638-9444
- **Mailing address:** 2323 CRIMSON CREEK LN, SNELLVILLE, GA 30078-5047
- **Mailing address phone:** (678) 638-9444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2012
- **Last updated:** 10/04/2012