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General NPI Number Information
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NPI Number | 1528940673
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Entity Type | Organization
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Legal Business Name | PINKY PROMISE CREATORS LLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 11053 ALIYAH DR
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City | HAMPTON
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State | GA
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Zip | 30228-4050
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Country | US
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Telephone | 818-930-1932
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Fax |
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Provider Business Mailing Address
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Address Line | 113 S PERRY ST STE 206
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4811
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Country | US
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Telephone | 818-930-1932
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Fax |
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Authorized Official
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Title or Position | CNA/OWNER
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Name | TAMEKA MONIQUE SNYDER
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Credential | CNA
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Telephone | 818-930-1932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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