Organization
HEAVENLY CARES ADULT DAY & PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALECIA RENE CLARK (OWNER)
(678) 603-2013
Entity
Organization
Contact information
Practice address
562 ELLES WAY, GRIFFIN, GA 30223-3579
(678) 603-2013
Mailing address
562 ELLES WAY, GRIFFIN, GA 30223-3579
(678) 603-2013
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
GA
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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