# MARION'S PERSONAL CARE HOME

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

## Provider details

- **NPI number:** 1902108558
- **Authorized official:** MERLYN KIRK (OWNER)
- **Authorized official phone:** (404) 578-2615

## Contact information

- **Practice address:** 942 PRESERVE PARK DR, LOGANVILLE, GA 30052-8315
- **Practice address phone:** (404) 578-2615
- **Mailing address:** 942 PRESERVE PARK DR, LOGANVILLE, GA 30052-8315
- **Mailing address phone:** (404) 578-2615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 2010008278 | GA | Yes |

## Other

- **Enumeration date:** 12/01/2010
- **Last updated:** 12/01/2010