Organization
ENERSED PERSONAL CARE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESRENE THOMPSON (PRESIDENT/CEO)
(404) 288-8026
Entity
Organization
Contact information
Practice address
3451 SPRINGRUN DR, DECATUR, GA 30032-6827
(404) 288-8026
Mailing address
3451 SPRINGRUN DR, DECATUR, GA 30032-6827
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000694053A
—
GA
Enumeration date
10/08/2008
Last updated
10/08/2008
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