Organization
COTTER PERSONAL CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
URICK LADONIS (OWNER)
(770) 226-4244
Entity
Organization
Contact information
Practice address
5146 COTTER DR, UNION CITY, GA 30291-1812
(770) 226-4244
Mailing address
PO BOX 310147, ATLANTA, GA 31131-0147
(770) 226-4244
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
241816
GA
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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