Healthcare Provider Details

I. General information

NPI: 1942629027
Provider Name (Legal Business Name): ANOTHER JOURNEY PERSONAL CARE HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8209 TAYLOR RD STE 200
RIVERDALE GA
30274-4307
US

IV. Provider business mailing address

8209 TAYLOR RD STE 200
RIVERDALE GA
30274-4307
US

V. Phone/Fax

Practice location:
  • Phone: 678-753-5528
  • Fax:
Mailing address:
  • Phone: 678-753-5528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: COREY L TURNER
Title or Position: CFO
Credential:
Phone: 678-753-5528