| NPI | 1780953018 |
|---|---|
| Former Legal Business Name | DADE PERSONAL CARE HOME (PCH) |
| Entity Type | Organization |
| Authorized Contact | DIAN EVADNE WALTERS-MOTT Owner/Director 678-768-5997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 376G00000X Nursing Home Administrator (Licence: GA 10701-081-1) |
| 376K00000X Nurse's Aide (Licence: GA CN0028872680) | |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |