| Organization Name: | THE MARY WASHINGTON ASSISTED LIVING HOME, INC |
| NPI Number: | 1003117615 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAWANA GRAY (CEO) |
| Mailing Address: | 590 Mountain Oaks Pkwy Stone Mountain |
| State: | GA US |
| Postal Code: | 300874732 |
| Phone Number: | 7704690155 |
| Fax Number: | 7704690155 |
| NPI Enumeration Date: | 11/12/2010 |
| NPI Last Update Date: | 11/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3104A0630X |
| License Number: | 044018141 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | Assisted Living, Behavioral Disturbances |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |