Provider Demographics
NPI:1750795480
Name:WHAT A DAY ADULT DAYCARE
Entity type:Organization
Organization Name:WHAT A DAY ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAMILL
Authorized Official - Middle Name:ALEAHA
Authorized Official - Last Name:MALLORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-996-0775
Mailing Address - Street 1:177 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3581
Mailing Address - Country:US
Mailing Address - Phone:770-996-0775
Mailing Address - Fax:770-478-2501
Practice Address - Street 1:177 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3581
Practice Address - Country:US
Practice Address - Phone:770-996-0775
Practice Address - Fax:770-478-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00967359AMedicaid
GA00967359BMedicaid