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General NPI Number Information
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NPI Number | 1528407368
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Entity Type | Organization
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Legal Business Name | AMORE COMMUNITY SERVICES INC
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 3720 NEWHALEM ST SW
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City | ATLANTA
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State | GA
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Zip | 30331-2243
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Country | US
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Telephone | 404-344-3074
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Fax | 404-344-3094
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Provider Business Mailing Address
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Address Line | 3720 NEWHALEM STREET S.W.
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City | ATLANTA
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State | GA
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Zip | 30331
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Country | US
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Telephone | 404-344-3074
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Fax | 404-344-3094
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Authorized Official
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Title or Position | RESIDENTIAL CARE MANAGER
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Name | MS. JACQUELINE ANN GIBSON
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Credential |
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Telephone | 404-344-3074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1501022172
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License Number State | GA
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