Organization
COTTAGE ADULT DAY SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATINA LAC KHAN (OWNER)
(770) 978-9696
Entity
Organization
Contact information
Practice address
1142 ATHENS HWY, GRAYSON, GA 30017-1709
(770) 978-9696
Mailing address
1142 ATHENS HWY, GRAYSON, GA 30017-1709
(770) 978-9696
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
305R00000X
Preferred Provider Organization
14000773
GA
Other
Enumeration date
04/14/2014
Last updated
11/01/2022
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