Provider Demographics
NPI:1083994339
Name:WE CARE OF MABLETON INC.
Entity Type:Organization
Organization Name:WE CARE OF MABLETON INC.
Other - Org Name:WE CARE OF MABLETON INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIOLET
Authorized Official - Middle Name:YYONNE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:770-896-7929
Mailing Address - Street 1:6313 ALLEN RD SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-4400
Mailing Address - Country:US
Mailing Address - Phone:770-896-7929
Mailing Address - Fax:770-819-1385
Practice Address - Street 1:6313 ALLEN RD SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-4400
Practice Address - Country:US
Practice Address - Phone:770-896-7929
Practice Address - Fax:770-819-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility