Healthcare Provider Details

I. General information

NPI: 1124802970
Provider Name (Legal Business Name): KAYRAM ATLANTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 FISH HATCHERY RD
GASTON SC
29053-9038
US

IV. Provider business mailing address

575 LAUREL OAKS LN
MILTON GA
30004-4507
US

V. Phone/Fax

Practice location:
  • Phone: 864-608-1820
  • Fax:
Mailing address:
  • Phone: 678-313-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: RAMESH RAMCHANDRAN
Title or Position: CEO
Credential:
Phone: 678-313-3034