Healthcare Provider Details

I. General information

NPI: 1013376516
Provider Name (Legal Business Name): UNTOUCHABLE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4990 DEMERE CT
STONE MTN GA
30083-2107
US

IV. Provider business mailing address

4990 DEMERE CT
STONE MTN GA
30083-2107
US

V. Phone/Fax

Practice location:
  • Phone: 615-377-7728
  • Fax:
Mailing address:
  • Phone: 615-377-7728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: BONITA JORDAN
Title or Position: OWNER
Credential:
Phone: 615-377-7728