Organization
PENISTON PERSONAL CARE HOME,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREEZY HOUSTON (CEO)
(678) 516-6555
Entity
Organization
Contact information
Practice address
4680 SUNDRIDGE TRL, FAIRBURN, GA 30213-1997
(678) 545-3934
(770) 892-1051
Mailing address
4680 SUNDRIDGE TRL, FAIRBURN, GA 30213-1997
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
GA
Other
Enumeration date
06/15/2017
Last updated
05/18/2023
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