Organization
ANTOINETTE FULLER
Active
Other names
Place Call Home Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANTOINETTE FULLER OWNER (OWNER OPERATOR)
(678) 519-0131
Entity
Organization
Contact information
Practice address
2024 REGISTRY DR, HAMPTON, GA 30228-6396
(678) 519-0131
Mailing address
2024 REGISTRY DR, HAMPTON, GA 30228-6396
(678) 519-0131
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
GA
311500000X
Alzheimer Center (Dementia Center)
—
GA
311ZA0620X
Adult Care Home Facility
—
GA
315D00000X
Inpatient Hospice
—
GA
Other
Enumeration date
11/17/2009
Last updated
07/21/2022
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