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TRANQUILITY PCH, LLC

Intermediate Care Mentally Retarded

Decatur, Georgia

Provider NPI: 1427336346

Organization Information:
Organization Name:  TRANQUILITY PCH, LLC
Organization is not Subpart
Authorized Official:  SHERYL  WRIGHT  CEO  404-5936386

Practice Location:
3440 RAINBOW DR  DECATUR, GA 30034 US
Tel: 404-593-6386  Fax: --

Business Mailing Address:
3440 RAINBOW DR  DECATUR, GA 30034 US
Tel: 404-593-6386  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
GA044-01-737-2

Other Provider Identifiers:

IssuerNumberStateType
291733345AGA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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