Provider Demographics
NPI:1073859666
Name:WHITNEY'S PLACE INC.
Entity Type:Organization
Organization Name:WHITNEY'S PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:NWAGBARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-245-8872
Mailing Address - Street 1:5451 ROCKBEIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088
Mailing Address - Country:US
Mailing Address - Phone:770-413-4235
Mailing Address - Fax:770-413-4235
Practice Address - Street 1:5451 ROCKBEIDGE ROAD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088
Practice Address - Country:US
Practice Address - Phone:770-413-4235
Practice Address - Fax:770-413-4235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home