Organization
GREEN PARKPCH,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATE EMEFIELE (ADMINISTRATOR)
(770) 596-4511
Entity
Organization
Contact information
Practice address
2941 SANDY PLAINS RD, MARIETTA, GA 30066-4652
(770) 596-4511
Mailing address
2941 SANDY PLAINS RD, MARIETTA, GA 30066-4652
(770) 596-4511
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
033-01-183-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104775A
—
GA
05
—
549666152A
—
GA
Enumeration date
08/19/2011
Last updated
08/19/2011
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