MEDICARE: BEE SOCIAL ADULT DAY PROGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1598230427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEE SOCIAL ADULT DAY PROGRAM

Provider Business Mailing Address
First Line	:	1915 ROCK CUT PL
Second Line	:
City	:	CONLEY
State	:	GA
Zip	:	30288-2104
Country	:	US
Telephone Number	:	404-806-7403
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 ROCK CUT PL
Second Line	:
City	:	CONLEY
State	:	GA
Zip	:	30288-2104
Country	:	US
Telephone Number	:	404-806-7403
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TONIE QUICK
Credential	:
Telephone Number	:	404-806-7403

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	10/08/2018

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