Organization
OPEN HEARTS PERSONAL CARE HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANNA ANNETTE CLARKSON (MANAGING PRINCIPAL)
(678) 410-1669
Entity
Organization
Contact information
Practice address
4031 BELMONT RIDGE DR, LITHONIA, GA 30038-4069
(770) 981-3497
Mailing address
3418 BRETON CT NE, ATLANTA, GA 30319-2408
(770) 323-3751
(404) 551-3448
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
754258102A
—
GA
Enumeration date
04/09/2007
Last updated
07/07/2008
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