New Domus Personal Care, Llc, NPI 1639377385
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in College Park, GA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1639377385 |
| NPI Entity Type | Organization |
| Provider Name | New Domus Personal Care, Llc |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 2650 Colonial Dr, College Park, GA, US |
| Provider Mailing Address | 6229 Johnson Rd, Riverdale, GA, US, 302741806 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | MR. Jackie Othella Smith JR. |
| Official Position | CEO |
| Phone | 770-996-6588 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Classification |
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Group | |
| License No. | 060-01-256-2 |
| License State | GA |
| Description | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
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