Organization
CHRIST THE KING DAY HABILITATION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUGUSTINA GIBSON (DIRECTOR)
(404) 767-4171
Entity
Organization
Contact information
Practice address
5155 SCOFIELD RD, COLLEGE PARK, GA 30349-3301
(404) 767-4171
(404) 559-8804
Mailing address
5155 SCOFIELD RD, COLLEGE PARK, GA 30349-3301
(404) 767-4171
(404) 559-8804
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
20065203
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134087992A
—
GA
05
—
134087992B
—
GA
Enumeration date
01/31/2007
Last updated
08/19/2022
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