NPI 1760856645

363l00000x

Organisation Nursing Facility/Intermediate Care Facility Atlanta, GA

Practice location

Address: 2171 Peachtree Rd NE APT 306, Atlanta, GA 30309-6300
Phone: (678) 464-9424

Authorised official

Name: Anetha Deborah Peterson
Title: Nurse Practitioner
Phone: (678) 464-9424

Registered specialties

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 363L00000X (GA)

Other Nursing Facility/Intermediate Care Facility providers in Georgia →

Registry record

NPI: 1760856645
Entity type: Organization
NPI issued: 16 Nov 2015
Record last updated: 16 Nov 2015

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.