Provider Demographics
NPI:1508102005
Name:GROUP HOMES FOR THE DISABLED, L.L.C.
Entity Type:Organization
Organization Name:GROUP HOMES FOR THE DISABLED, L.L.C.
Other - Org Name:GHFTD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:CRC
Authorized Official - Phone:678-508-3983
Mailing Address - Street 1:624 PAGE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1734
Mailing Address - Country:US
Mailing Address - Phone:678-508-3983
Mailing Address - Fax:404-448-4696
Practice Address - Street 1:3275 IDLECREEK CT
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4914
Practice Address - Country:US
Practice Address - Phone:678-508-3983
Practice Address - Fax:404-448-4696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home