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Organization

TEMPLE PERSONAL CARE HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIE GERTRUDE BITOTA TSHIMANGA (DIRECTOR)
(404) 660-1571
Entity
Organization

Contact information

Practice address
838 SHADYBROOK DR NE, MARIETTA, GA 30066-6215
(404) 660-1571
Mailing address
838 SHADYBROOK DR NE, MARIETTA, GA 30066-6215
(404) 660-1571

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary

Other

Enumeration date
09/08/2019
Last updated
09/08/2019
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