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Organization
FRAGMENTS MINISTRY, INC
Active
Organization
FRAGMENTS MINISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD LEON CLOUD MINISTER (EXECTIVE DIRECTOR)
(678) 598-0651
Entity
Organization
Contact information
Practice address
635 PEARCE ST SW, ATLANTA, GA 30310-2829
(404) 755-3237
(404) 755-3237
Mailing address
5793 JAMES RD, AUSTELL, GA 30168-4505
(678) 598-0651
(404) 755-3237
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082412
GEORGIA ASSOCIATION OF RECOVERY RESIDENTS MEMBER STANDARDS
GA
01
—
102612
CERTIFIED BY THE STATE OF GA TO OPERATE AS A SUPPORTIVE HOUSING FACILITY
GA
Enumeration date
10/12/2012
Last updated
10/12/2012
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