Organization
AMELIA GARDENS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ISOKEN J ONAIWU (OWNER)
(770) 712-4903
Entity
Organization
Contact information
Practice address
576 NICKAJACK RD SW, MABLETON, GA 30126-1419
(770) 712-4903
Mailing address
576 NICKAJACK RD SW, MABLETON, GA 30126-1419
(770) 712-4903
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
033-02-028-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003168137A
—
GA
Enumeration date
11/16/2016
Last updated
11/16/2016
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