Provider Demographics
NPI:1225768823
Name:YOUR PARENTS PLACE
Entity Type:Organization
Organization Name:YOUR PARENTS PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ARTIST
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR OF NURSING
Authorized Official - Phone:313-742-6780
Mailing Address - Street 1:7180 SOUTHLAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-4178
Mailing Address - Country:US
Mailing Address - Phone:770-698-6994
Mailing Address - Fax:678-519-0645
Practice Address - Street 1:7180 SOUTHLAKE PKWY
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-4178
Practice Address - Country:US
Practice Address - Phone:770-698-6994
Practice Address - Fax:678-519-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No385H00000XRespite Care FacilityRespite Care