Organization · Type 2 NPI

Rising Star Personal Care Home LLC

Assisted Living Facility · Stone Mountain, GA

NPI number 1790174944 Active

Practice location

5018 E Ponce De Leon Ave
Stone Mountain, GA 30083-1236

Fax (678) 904-5628

Specialties and licenses

Taxonomy	Code	License
Home Health Agency	251E00000X	None listed
Assisted Living Facility Primary	310400000X	PCH009075 (GA)
Non-emergency Medical Transport (VAN)	343900000X	None listed
Home Health Aide	374U00000X	None 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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NPI record

NPI: 1790174944
Entity type: Organization (Type 2)
Issued: Jan 12, 2015
Last updated: Jan 30, 2024
Status: Active
Subpart: Yes of Rising Star Home Healthcare LLC

Other names

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Rising Star Personal Care Home · doing business as
Rising Star Home Health Care Services, LLC · other name

Authorized official

Terrie Lisa McGill
Director of Operations
(678) 701-5115

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790174944

Rising Star Personal Care Home LLC's National Provider Identifier is 1790174944, issued on Jan 12, 2015. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Stone Mountain, GA. The record was last updated on Jan 30, 2024.