Organization
ASSISTCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PANOME THEPMANIVONG (CFO/OWNER)
(678) 557-2229
Entity
Organization
Contact information
Practice address
3576 CHAMBLEE TUCKER RD, ATLANTA, GA 30341-4424
(404) 836-1989
Mailing address
3576 CHAMBLEE TUCKER RD, ATLANTA, GA 30341-4424
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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