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Tudor Castle Community Home

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Decatur, GA

NPI 1467517409 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1467517409
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
044232 (GA)
Legal business name
TUDOR CASTLE COMMUNITY HOME
Practice address
2056 Tudor Castle Cir
Decatur, GA 30035-2154
Phone
(678) 518-9280
NPI assigned
Dec 27, 2006
Organization subpart
No

Authorized official

Name
Jackie Foster-Rice
Title
Administrator
Phone
(404) 243-2353

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Roosevelt Warm SGP Inst (74 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 044232 GA Yes

Addresses

Primary practice location

2056 Tudor Castle Cir
Decatur, GA 30035-2154

Mailing address

2056 Tudor Castle Cir
Decatur, GA 30035-2154
Phone (678) 518-9280

Other identifiers

IdentifierTypeStateIssuer
00954324FMedicaidGA

Other providers in Decatur, GA

All providers in Decatur, GA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

Sources for this page

Verify at the official NPI Registry.