Organization Name: | GENTILITY PERSONAL CARE HOME, LLC |
NPI Number: | 1336314541 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRANDI MARIE NESBITT (EXECUTIVE DIRECTOR) |
Mailing Address: | 2803 Austin Ridge Dr Dacula |
State: | GA US |
Postal Code: | 300196108 |
Phone Number: | 6789775134 |
Fax Number: | 6782262944 |
NPI Enumeration Date: | 04/29/2008 |
NPI Last Update Date: | 04/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | 061-01-320-9 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |