Organization Name: | CHELSEA PERSONAL CARE HOME, LLC |
NPI Number: | 1801183892 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELISSA D THIOMPSON (CEO) |
Mailing Address: | 2333 Brookgate Way Ellenwood |
State: | GA US |
Postal Code: | 302942398 |
Phone Number: | 4043704144 |
Fax Number: | 4047450239 |
NPI Enumeration Date: | 06/29/2011 |
NPI Last Update Date: | 06/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | PCH008063 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical 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. |