Organization
SAMO HOLDINGS, INC
Active
Other names
Amina's Home
Organization subpart
No
Provider details
NPI number
Authorized official
MOSES DEMBA (CEO)
(404) 729-2514
Entity
Organization
Contact information
Practice address
5530 SWANSON RD, ELLENWOOD, GA 30294-3857
(404) 729-2514
(678) 264-5461
Mailing address
2467 CHAUNCEY LN SW, MARIETTA, GA 30064-4536
(404) 729-2514
(678) 264-5461
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
031013109
GA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
031013109
GA
Other
Enumeration date
04/11/2011
Last updated
04/11/2011
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