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Organization
SUPREME CARE HOUSING LLC
Active
Organization
SUPREME CARE HOUSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS LOGAN (CEO)
(770) 585-3029
Entity
Organization
Contact information
Practice address
334 BETSY AVE SW, ATLANTA, GA 30310-1008
(770) 585-3029
Mailing address
3379 PEACHTREE RD NE STE 555, ATLANTA, GA 30326-1418
(770) 585-3029
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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