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General NPI Number Information
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NPI Number | 1386995017
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Entity Type | Organization
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Legal Business Name | JONES CODY PERSONAL CARE HOME INC
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 787 WYNBROOKE PKWY
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-6323
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Country | US
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Telephone | 404-484-0054
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 ALBANS CT
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City | LITHONIA
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State | GA
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Zip | 30058-5639
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Country | US
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Telephone | 404-484-0054
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. DORIS JONES CODY
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Credential |
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Telephone | 404-484-0054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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