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Organization
KENNY'S PERSONAL CARE HOME
Active
Organization
KENNY'S PERSONAL CARE HOME
Active
Other names
Kenny's Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
KENYON LINDSEY CEO, COUNSELOR (CEO)
(770) 899-2849
Entity
Organization
Contact information
Practice address
4043 BIG VALLEY TRL, STONE MOUNTAIN, GA 30083-5711
(770) 676-0766
(770) 676-0766
Mailing address
4043 BIG VALLEY TRL, STONE MOUNTAIN, GA 30083-5711
(770) 676-0766
(770) 676-0766
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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