Organization
HEAVENLY ARMS ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIDA THOMPSON (CEO)
(678) 342-7537
Entity
Organization
Contact information
Practice address
11230 HIGHWAY 278 E, COVINGTON, GA 30014-1673
(678) 342-7537
(678) 625-4216
Mailing address
11230 HIGHWAY 278 E, COVINGTON, GA 30014-1673
(678) 342-7537
(678) 625-4216
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
107010431
GA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
107010431
GA
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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