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General NPI Number Information
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NPI Number | 1033482369
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Entity Type | Organization
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Legal Business Name | A PLACE FOR COMFORT LLC
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 1766 BIG VALLEY LN
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-5712
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Country | US
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Telephone | 678-615-3841
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82542
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City | CONYERS
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State | GA
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Zip | 30013-9437
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Country | US
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Telephone | 404-831-8502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SELMA GILCREASE
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Credential |
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Telephone | 404-831-8502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | PCH001362
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | PCH001362
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License Number State | GA
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