Organization
DIGNITY CARE HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEVERLY AGEE BARNWELL (EXECUTIVE DIRECTOR)
(678) 629-3267
Entity
Organization
Contact information
Practice address
603 EFFIE DR, LAWRENCEVILLE, GA 30045-3808
(678) 629-3267
Mailing address
603 EFFIE DR, LAWRENCEVILLE, GA 30045-3808
(678) 629-3267
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2011015696
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003351727A
—
GA
Enumeration date
05/30/2012
Last updated
05/30/2012
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