NPI 1639377385

New Domus Personal Care, LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility College Park, GA

Practice location

Address: 2650 Colonial Dr, College Park, GA 30337-4923
Phone: (404) 209-9296
Mailing address: 6229 Johnson Rd, Riverdale, GA 30274-1806

Authorised official

Name: Jackie Othella Smith
Title: Ceo
Phone: (770) 996-6588

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 060-01-256-2 (GA)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Georgia →

Registry record

NPI: 1639377385
Entity type: Organization
NPI issued: 4 Jul 2007
Record last updated: 26 Aug 2016

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.