PROVIDENT GROUP - CREEKSIDE PROPERTIES LLC is an assisted living facility in Smyrna, GA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PROVIDENT GROUP - CREEKSIDE PROPERTIES LLC NPI is 1891287645. The provider is registered as an organization entity type.
The provider Is Doing Business As Provident Village At Creekside.
The provider's business location address is:
4838 SOUTH COBB DRIVE
SMYRNA, GA
ZIP 30080
Phone: (678) 710-1834
Fax: (678) 236-0374
The provider's authorized official is Debra W. Lockwood .
The authorized official title is President & Chief Financial Officer and has the following contact phone number (225) 766-3977.
The CLIA number assigned to this NPI record is 11D2122676 - assisted living facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/6/2018 and was last updated on 6/6/2018.