NPI 1760609895

Cassandra Gilliam

Organisation Mental Illness Intermediate Care Facility Decatur, GA

Practice location

Address: 450 Winn Way, Decatur, GA 30030-1715
Phone: (404) 294-0499
Mailing address: 3850 Eden Glen Dr SE, Conyers, GA 30013-5813

Authorised official

Name: Cassandra Shea Gilliam
Title: RN
Phone: (404) 294-0499

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence RN171251 (GA)

Other Intermediate Care Facility, Mental Illness providers in Georgia →

Registry record

NPI: 1760609895
Entity type: Organization
NPI issued: 19 Apr 2007
Record last updated: 22 Aug 2020

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.