Provider Demographics
NPI:1235260258
Name:CHARITY PERSONAL CARE HOME L.L.C.
Entity Type:Organization
Organization Name:CHARITY PERSONAL CARE HOME L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:CHINASA
Authorized Official - Last Name:EKPERI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NP
Authorized Official - Phone:404-519-5248
Mailing Address - Street 1:2995 GARNET WAY
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-8440
Mailing Address - Country:US
Mailing Address - Phone:404-519-5248
Mailing Address - Fax:
Practice Address - Street 1:2995 GARNET WAY
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-8440
Practice Address - Country:US
Practice Address - Phone:404-519-5248
Practice Address - Fax:770-473-3546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities