National Provider Identifier Database

PANOLA CARE CLA
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.


Contact Information

PANOLA CARE, CLA
3169 PEQUEA DR
LITHONIA, GA30038-1119
Phone: 770-322-6810
Fax: 770-322-6810
Website:
Specialty Taxonomy Code
* Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X
Residential Treatment Facility, Physical Disabilities 320700000X

* Indicates primary specialty

NPI Profile & details for PANOLA CARE, CLA

NPI Number 1134564131
Legal business name
LBN
PANOLA CARE, CLA
Authorized official CAROL TAVARES - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 05/03/2013
Last updated 05/03/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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