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General NPI Number Information
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NPI Number | 1902030653
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Entity Type | Organization
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Legal Business Name | APREMIER ASSISTED LIVING FACILITY
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 2331 FLAT SHOALS RD
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City | RIVERDALE
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State | GA
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Zip | 30296-2311
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Country | US
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Telephone | 404-604-8126
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Fax |
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Provider Business Mailing Address
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Address Line | 2331 FLAT SHOALS RD
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City | RIVERDALE
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State | GA
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Zip | 30296-2311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FACILITY ADMINISTRATOR
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Name | THERESA FOSTER-FRITSCH
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Credential | RN
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Telephone | 404-574-8543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | GA
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