Organization
A UNIQUE PERSONAL CARE HOME,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA LECOUNTE WILEY ORS (CEO)
(678) 595-4938
Entity
Organization
Contact information
Practice address
1517 BORDEAUX LN, CONYERS, GA 30094-1109
(770) 679-4437
Mailing address
4127 KINGSHIP DR, ELLENWOOD, GA 30294-4211
(404) 212-0057
(770) 679-4437
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
GA
Other
Enumeration date
10/07/2007
Last updated
10/07/2007
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