Healthcare Provider Details

I. General information

NPI: 1194896407
Provider Name (Legal Business Name): THE GUEST HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 TOWER HEIGHTS RD
GAINESVILLE GA
30501-8525
US

IV. Provider business mailing address

320 TOWER HEIGHTS RD
GAINESVILLE GA
30501-8525
US

V. Phone/Fax

Practice location:
  • Phone: 770-535-1487
  • Fax: 770-536-4264
Mailing address:
  • Phone: 770-535-1487
  • Fax: 770-536-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOCELYN PRYOR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 770-535-1487