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Allgood Manor Assistant Home Inc.
Intellectual Disabilities Intermediate Care Facility in Lithonia, Georgia
NPI 1720318843

Allgood Manor Assistant Home Inc. is a Intellectual Disabilities Intermediate Care Facility based in Lithonia, GA. Allgood Manor Assistant Home Inc. practices in Lithonia, GA. The NPI Number for Allgood Manor Assistant Home Inc. is 1720318843 and holds a License No. 044-01-594-1 (Georgia).

The current practice location address for Allgood Manor Assistant Home Inc. is 6358 Deshong Dr, Lithonia, GA and can be reached out via phone at 678-526-9201.

Location: 6358 Deshong Dr, Lithonia, GA, 30058-6123
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1720318843
Provider Name
Allgood Manor Assistant Home Inc.
Credential
Provider Entity Type
Organization
Address
6358 Deshong Dr, Lithonia, GA, 30058-6123
Phone Number
678-526-9201
Fax Number
Provider Enumeration Date
01/12/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
129286824A 01 GA MEDICAID PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
6358 Deshong Dr
City
Lithonia
State
Georgia
Zip
30058-6123
Phone Number
678-526-9201
Fax Number
person
Provider Business Mailing Address Details
Address
6358 Deshong Dr
City
Lithonia
State
Georgia
Zip
30058-6123
Phone Number
678-526-9201
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
044-01-594-1 (Georgia)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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