New Domus Personal Care, LLC
NPI #1639377385 in College Park, Georgia
Provider Information
- NPI Number
- 1639377385
- Entity Type
- Organization
- Organization Name
- New Domus Personal Care, LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jul 4, 2007
- Last Updated
- Aug 26, 2016
Practice Location
- Address
- 2650 COLONIAL DR
- City
- College Park
- State
- Georgia
- ZIP Code
- 30337-4923
- Phone
- (404) 209-9296
Authorized Official
- Name
- MR. JACKIE OTHELLA SMITH JR.
- Title
- CEO
- Phone
- (770) 996-6588
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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