Organization
FREEDOM REST OF KENNESAW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YOLANDA LETICE WILSON (DIRECTOR)
(678) 499-6426
Entity
Organization
Contact information
Practice address
3351 OWENS BROOK WAY NW, KENNESAW, GA 30152-2566
(770) 693-0863
(770) 693-0863
Mailing address
3351 OWENS BROOK WAY NW, KENNESAW, GA 30152-2566
(770) 693-0863
(770) 693-0863
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PCH006452
GA
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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