Healthcare Provider Details

I. General information

NPI: 1699653543
Provider Name (Legal Business Name): RUTH'S PLACE COMMUNITY HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 LOCKHEED AVE SE
MARIETTA GA
30060-2804
US

IV. Provider business mailing address

340 LOCKHEED AVE SE
MARIETTA GA
30060-2804
US

V. Phone/Fax

Practice location:
  • Phone: 800-376-1071
  • Fax: 844-710-4357
Mailing address:
  • Phone: 800-376-1071
  • Fax: 844-710-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANDREA DANIELS
Title or Position: DIRECTOR
Credential:
Phone: 800-376-1071