NPI 1457623308

Patron Place LLC

Organisation Assisted Living Facility Stone Mountain, GA

Practice location

Address: 1227 Rockbridge Rd STE 208-196, Stone Mountain, GA 30087-3064
Phone: (770) 573-1076
Fax: (770) 234-5894

Authorised official

Name: Rondine Gordon
Title: Owner/Administrator
Phone: (770) 573-1076

Registered specialties (3)

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence PCH006520 (GA)

Other Assisted Living Facility providers in Georgia →

Custodial Care Facility

Nursing & Custodial Care Facilities Taxonomy 311Z00000X Licence PCH006520 (GA)

Other Custodial Care Facility providers in Georgia →

Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence PCH006520 (GA)

Registry record

NPI: 1457623308
Entity type: Organization
NPI issued: 7 Feb 2012
Record last updated: 7 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.