Organization
CHEROKEE ANGEL SENIOR CARE & TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINIQUE R LOUIS (OWNER)
(404) 918-3066
Entity
Organization
Contact information
Practice address
2442 MARIETTA HWY, SUITE 100, CANTON, GA 30114-4023
(404) 918-3066
Mailing address
2442 MARIETTA HWY, SUITE 100, CANTON, GA 30114-4023
(404) 918-3066
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ADC000107
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003130496A
—
GA
05
—
003152115A
—
GA
05
—
003152115C
—
GA
Enumeration date
10/06/2015
Last updated
10/06/2015
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