Organization
AGELESS HEALTH CARE & ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE PEAN (OWNER)
(678) 526-5464
Entity
Organization
Contact information
Practice address
1300 ROCK CHAPEL RD, LITHONIA, GA 30058-5835
(678) 526-5464
Mailing address
1300 ROCK CHAPEL RD, LITHONIA, GA 30058-5835
(678) 526-5464
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
GA
Other
Enumeration date
02/29/2008
Last updated
02/29/2008
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