Organization
GUARDIAN ANGELS ADULT COMMUNITY LIVING LLC
Active
Organization
GUARDIAN ANGELS ADULT COMMUNITY LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CASSANDRA SIMONE HICKS (HEALTH SYSTEMS MANAGER)
(770) 666-4401
Entity
Organization
Contact information
Practice address
6672 HILL CREEK CV, LITHONIA, GA 30058-7001
(770) 666-4401
Mailing address
6672 HILL CREEK CV, LITHONIA, GA 30058-7001
(770) 666-4401
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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