Organization
HEAVENLY ARMS ASSISTED LIVING PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDA A L THOMPSON (OWNER)
(678) 625-4216
Entity
Organization
Contact information
Practice address
11230 HIGHWAY 278 E, COVINGTON, GA 30014-1673
(678) 625-4216
(678) 625-7793
Mailing address
11230 HIGHWAY 278 E, COVINGTON, GA 30014-1673
(678) 625-4216
(678) 625-7793
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
BLP-18639
GA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
BLP-18639
GA
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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