Organization · Type 2 NPI

Wickshire Canton Opco LLC

Assisted Living Facility · Canton, GA

NPI number 1619516093 Active

Practice location

125 Riverstone Terrace
Canton, GA 30114

Call (770) 720-9669 Map

Fax (678) 880-3689

Mailing address

750 Old Hickory Blvd, Building One Suite 125
Brentwood, TN 37027

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed

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.

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About NPI 1619516093

Wickshire Canton Opco LLC's National Provider Identifier is 1619516093, issued on Jan 2, 2020. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Canton, GA. The record was last updated on Jan 2, 2020.