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THE MARY WASHINGTON ASSISTED LIVING HOME INC NPI 1003117615


NPI Information

NPI: 1003117615
Provider Name: THE MARY WASHINGTON ASSISTED LIVING HOME, INC
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
590 MOUNTAIN OAKS PKWY
STONE MOUNTAIN, GA
ZIP 30087
Phone: (770) 469-0155
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THE MARY WASHINGTON ASSISTED LIVING HOME, INC is an assisted living and mental illness assisted living facility in Stone Mountain, GA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. THE MARY WASHINGTON ASSISTED LIVING HOME, INC NPI is 1003117615. The provider is registered as an organization entity type.

The provider's business location address is:

590 MOUNTAIN OAKS PKWY
STONE MOUNTAIN, GA
ZIP 30087-732
Phone: (770) 469-0155
Fax: (770) 469-0155

The provider's authorized official is Tawana Gray .
The authorized official title is Ceo and has the following contact phone number (770) 469-0155.

The enumeration date for this NPI number is 11/12/2010 and was last updated on 11/12/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13104A0630XAssisted Living FacilityAssisted Living, Behavioral Disturbances044018141GEORGIANo
23104A0625XAssisted Living FacilityAssisted Living, Mental Illness044018141GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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