Organization
DISTINCTIVELY YOURS OF GEORGIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA N WARNER (DIRECTOR/CEO)
(770) 507-0125
Entity
Organization
Contact information
Practice address
8435 MAGNOLIA DR, JONESBORO, GA 30238-3132
(770) 507-0125
(770) 507-9075
Mailing address
8435 MAGNOLIA DR, JONESBORO, GA 30238-3132
(678) 479-9462
(770) 507-9075
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003108953B
—
GA
05
—
003108953D
—
GA
05
—
003108953E
—
GA
Enumeration date
04/29/2013
Last updated
04/28/2015
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