Organization · NPI-2

Aiden'S Place, LLC

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Atlanta, GA

NPI number1316221815
StatusActive
Last updated in NPPESOct 3, 2011

Details

NPI
1316221815
Entity type
Organization (NPI-2)
Legal business name
Aiden'S Place, LLC
Organization subpart
No
Enumeration date
Oct 3, 2011
Last updated
Oct 3, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesPCH008079GAYes
320800000X Community Based Residential Treatment Facility, Mental IllnessPCH008079GA

Practice location

7370 Wright Dr
Atlanta, GA 30349-7911

Phone 770-573-1076 · Fax 770-234-5894

Mailing address

1227 Rockbridge Rd
Suite 208-196
Stone Mountain, GA 30087-3064

Phone 770-573-1076 · Fax 770-234-5894

Authorized official

Rondine D Gordon
Ceo
7705731076

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