Organization
MARION'S PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERLYN KIRK (OWNER)
(404) 578-2615
Entity
Organization
Contact information
Practice address
942 PRESERVE PARK DR, LOGANVILLE, GA 30052-8315
(404) 578-2615
Mailing address
942 PRESERVE PARK DR, LOGANVILLE, GA 30052-8315
(404) 578-2615
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
2010008278
GA
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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