# HEAVENLY CARES ADULT DAY & PERSONAL CARE HOME

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

## Provider details

- **NPI number:** 1740581347
- **Authorized official:** ALECIA RENE CLARK (OWNER)
- **Authorized official phone:** (678) 603-2013

## Contact information

- **Practice address:** 562 ELLES WAY, GRIFFIN, GA 30223-3579
- **Practice address phone:** (678) 603-2013
- **Mailing address:** 562 ELLES WAY, GRIFFIN, GA 30223-3579
- **Mailing address phone:** (678) 603-2013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | GA | Yes |

## Other

- **Enumeration date:** 11/12/2010
- **Last updated:** 11/12/2010