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ANTOINETTE FULLER NPI 1588991236


NPI Information

NPI: 1588991236
Provider Name: ANTOINETTE FULLER

Other Name: PLACE CALL HOME PERSONAL CARE HOME

Classification: Assisted Living Facility - 3104A0630X
Entity Type: Organization

Specialization: Assisted Living, Behavioral Disturbances

Address:
2024 REGISTRY DR
HAMPTON, GA
ZIP 30228
Phone: (678) 519-0131
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ANTOINETTE FULLER is an assisted living and behavioral disturbances assisted living facility in Hampton, GA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. ANTOINETTE FULLER NPI is 1588991236. The provider is registered as an organization entity type.
The provider Other Name Is Place Call Home Personal Care Home.

The provider's business location address is:

2024 REGISTRY DR
HAMPTON, GA
ZIP 30228-396
Phone: (678) 519-0131

The provider's authorized official is Antoinette Fuller .
The authorized official title is Owner Operator and has the following contact phone number (678) 519-0131.

The enumeration date for this NPI number is 11/17/2009 and was last updated on 7/21/2022.


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
1311500000XAlzheimer Center (Dementia Center)GEORGIANo
2311ZA0620XCustodial Care FacilityAdult Care HomeGEORGIANo
3315D00000XHospice, InpatientGEORGIANo
43104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesGEORGIAYes

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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