Provider Demographics
NPI:1982989794
Name:A PLACE OF MOTHERLY LOVE, INC
Entity Type:Organization
Organization Name:A PLACE OF MOTHERLY LOVE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHENEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-353-9432
Mailing Address - Street 1:4299 BELLWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7074
Mailing Address - Country:US
Mailing Address - Phone:770-969-2539
Mailing Address - Fax:770-969-2539
Practice Address - Street 1:4299 BELLWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-7074
Practice Address - Country:US
Practice Address - Phone:770-969-2539
Practice Address - Fax:770-969-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle