Organization
MY HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA RENEE BRAZIL (DIRECTOR)
(770) 978-0791
Entity
Organization
Contact information
Practice address
2721 RAVEN WOOD DR, SNELLVILLE, GA 30078-3739
(770) 978-0791
(678) 325-1529
Mailing address
2721 RAVENWOOD DRIVE, SNELLVILLE, GA 30078
(770) 978-0791
(678) 325-1529
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
067011511
GA
Other
Enumeration date
08/27/2010
Last updated
10/21/2010
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