| Grandma's Porch Family Support Services Llc | |
|
3915 Cascade Rd Sw Suite T132 Atlanta GA 30331-8512 | |
| (678) 607-5735 | |
| Not Available |
| Full Name | Grandma's Porch Family Support Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3915 Cascade Rd Sw, Atlanta, Georgia |
| Authorized Official Name and Position | Dietra Taylor (OWNER) |
| Authorized Official Contact | 6786075735 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grandma's Porch Family Support Services Llc 1466 Copeland Ave Sw Atlanta GA 30310-2501 Ph: (202) 250-9420 | Grandma's Porch Family Support Services Llc 3915 Cascade Rd Sw Suite T132 Atlanta GA 30331-8512 Ph: (678) 607-5735 |
| NPI Number | 1154794410 |
|---|---|
| Provider Enumeration Date | 11/09/2015 |
| Last Update Date | 11/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154794410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC006401 (Georgia) | Primary |
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