Organization
DALIA PRECIOUS MEMORIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIA SMITH (CEO/ADMINISTRATOR)
(678) 829-3900
Entity
Organization
Contact information
Practice address
2083 BETHSAIDA RD, RIVERDALE, GA 30296-1861
(678) 829-3900
Mailing address
2083 BETHSAIDA RD, RIVERDALE, GA 30296-1861
(678) 829-3900
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003231273B
—
GA
Enumeration date
02/15/2023
Last updated
02/15/2023
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