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Organization
HOME AWAY FROM HOME
Active
Organization
HOME AWAY FROM HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE BURROW-JOHNSON (CEO)
(770) 289-3682
Entity
Organization
Contact information
Practice address
5031 GLORE RD SW, MABLETON, GA 30126-5509
(770) 289-3682
(678) 321-1464
Mailing address
5031 GLORE RD SW, MABLETON, GA 30126-5509
(770) 289-3682
(678) 321-1464
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
01/22/2016
Last updated
01/22/2016
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