Healthcare Provider Details

I. General information

NPI: 1578426458
Provider Name (Legal Business Name): BEYOND CARE MANOR 'PERSONAL CARE HOME' LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 WELLINGTON WAY
JONESBORO GA
30238-4451
US

IV. Provider business mailing address

1400 JR GRANT BLVD APT 1107
MCDONOUGH GA
30253-8408
US

V. Phone/Fax

Practice location:
  • Phone: 470-402-0831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SANTERIA A COLLIER
Title or Position: OWNER/OPERATER
Credential:
Phone: 470-402-0831