National Provider Identifier Database

EXQUISITE TRADITIONS
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

EXQUISITE TRADITIONS
7265 MOUNT ZION BLVD
JONESBORO, GA30236-2519
Phone: 404-525-9500
Fax: 404-393-9436
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X
Residential Treatment Facility, Physical Disabilities 320700000X

* Indicates primary specialty

NPI Profile & details for EXQUISITE TRADITIONS

NPI Number 1558657494
Legal business name
LBN
EXQUISITE TRADITIONS
Authorized official KYLE BALLIF - (CEO)
Entity Organization
Organization subpart No
Enumeration date 06/20/2011
Last updated 06/20/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PCH001261

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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