Lowes Guardian Angel LLC

NPI #1942571625 in Riverdale, Georgia

Provider Information

NPI Number: 1942571625
Entity Type: Organization
Organization Name: Lowes Guardian Angel LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 26, 2012
Last Updated: Jan 26, 2012

Practice Location

Address: 7056 EUNICE DR.
City: Riverdale
State: Georgia
ZIP Code: 30274
Phone: (678) 586-3171

Authorized Official

Name: MR. GLENN ALAN LOWE, BA
Title: DDP
Phone: (404) 808-4859

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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