Organization
KENNY'S PERSONAL CARE HOME
Active
Other names
Kenny's Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
KENYON LINDSEY CEO, COUNSELOR (CEO)
(770) 899-2849
Entity
Organization
Contact information
Practice address
4043 BIG VALLEY TRL, STONE MOUNTAIN, GA 30083-5711
(770) 676-0766
(770) 676-0766
Mailing address
4043 BIG VALLEY TRL, STONE MOUNTAIN, GA 30083-5711
(770) 676-0766
(770) 676-0766
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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