Organization · Type 2 NPI
Sid's Place Incorporated
Assisted Living Facility · Ellenwood, GA
NPI number
1174823595
Active
Practice location
2742 Luke Dr
Ellenwood, GA 30294-3987
Fax (404) 521-4888
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility Primary | 310400000X | 031012928 (GA) |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 031012928 (GA) |
Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Other assisted living facility providers in Ellenwood
About NPI 1174823595
Sid's Place Incorporated's National Provider Identifier is 1174823595, issued on Nov 1, 2010. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Ellenwood, GA. The record was last updated on Nov 1, 2010.