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Organization
GROWTH BRIDGE SPARKS PCH LLC
Active
Organization
GROWTH BRIDGE SPARKS PCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE OFORI MD (ADMINISTRATOR)
(770) 568-3923
Entity
Organization
Contact information
Practice address
204 S GOODMAN ST, SPARKS, GA 31647-7549
(229) 234-9775
Mailing address
3116 HOLLY MILL RUN, MARIETTA, GA 30062-5460
(770) 609-7610
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/10/2026
Last updated
09/10/2026
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