Organization
PRESTIGE COMMUNITY LIVING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEYEMI MAKANJUOLA (CEO)
(678) 761-5414
Entity
Organization
Contact information
Practice address
2328 BIGWOOD TRL, ATLANTA, GA 30349-9049
(678) 983-4330
Mailing address
2328 BIGWOOD TRL, ATLANTA, GA 30349-9049
(678) 983-4330
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
PCH008531
GA
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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