363L00000X is a nursing facility intermediate care facility in Atlanta, GA. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. 363L00000X NPI is 1760856645. The provider is registered as an organization entity type.
The provider's business location address is:
2171 PEACHTREE RD NE
APT 306
ATLANTA, GA
ZIP 30309-300
Phone: (678) 464-9424
The provider's authorized official is Anetha Deborah Peterson .
The authorized official title is Nurse Practitioner and has the following contact phone number (678) 464-9424.
The enumeration date for this NPI number is 11/16/2015 and was last updated on 11/16/2015.