Organization
IJN CHILD & ADULT CARE HOMES
Active
Organization
IJN CHILD & ADULT CARE HOMES
Active
Other names
IJN Adult Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GINA BLAKE (DIRECTOR)
(404) 447-0800
Entity
Organization
Contact information
Practice address
1949 VICKI LANE, ATLANTA, GA 30316-4108
(404) 447-0800
(404) 284-7478
Mailing address
P.O. BOX 370213, DECATUR, GA 30037-0213
(404) 447-0800
(404) 284-7478
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
416579002A
GA
Other
Enumeration date
10/21/2010
Last updated
10/21/2010
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