Organization
PHOENIX HAVEN AFRICA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TATO GAYFLORSEE ADMINISTRATOR, MPA (EXECUTIVE DIRECTOR)
(404) 437-9073
Entity
Organization
Contact information
Practice address
115 E MAIN ST, BUFORD, GA 30518-5727
(470) 593-8438
Mailing address
3808 PROSPECT POINT DR, OAKWOOD, GA 30566-0350
(470) 872-7208
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
146D00000X
Personal Emergency Response Attendant
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
332U00000X
Home Delivered Meals
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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