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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