Organization
MINERS CREEK PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA MAE THOMPSON (OWNER ADMINISTRATOR)
(404) 641-6275
Entity
Organization
Contact information
Practice address
4227 MINERS CREEK RD, LITHONIA, GA 30038-3814
(404) 641-6275
Mailing address
5506 STONELEIGH CT, STONE MOUNTAIN, GA 30088-3433
(404) 641-6275
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
044017069
GA
Other
Enumeration date
05/04/2008
Last updated
05/04/2008
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