MEDICARE: GUEST HOUSE 1 INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	347C00000X	Private Vehicle
2	251B00000X	Case Management Agency
3	251X00000X	Supports Brokerage Agency
4	343800000X	Secured Medical Transport (VAN)
5	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1376406256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUEST HOUSE 1 INC

Provider Business Mailing Address
First Line	:	4905 JONESBORO RD
Second Line	:
City	:	UNION CITY
State	:	GA
Zip	:	30291-1919
Country	:	US
Telephone Number	:	770-703-4825
Fax Number	:

Provider Business Practice Location Address
First Line	:	3890 STONEWALL TELL RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-1415
Country	:	US
Telephone Number	:	770-703-4825
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. KIANA AUGUSTUS
Credential	:
Telephone Number	:	404-421-1915

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “GUEST HOUSE 1 INC ” Practice Location

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