| Yilla Personal Care Home, Inc | |
|
6226 Windy Ridge Trl Lithonia GA 30058-6625 | |
| (631) 848-3740 | |
| (770) 783-6604 |
| Full Name | Yilla Personal Care Home, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6226 Windy Ridge Trl, Lithonia, Georgia |
| Authorized Official Name and Position | Racquel Yilla (CEO) |
| Authorized Official Contact | 6318483740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Yilla Personal Care Home, Inc 6226 Windy Ridge Trl Lithonia GA 30058-6625 Ph: (631) 848-3740 | Yilla Personal Care Home, Inc 6226 Windy Ridge Trl Lithonia GA 30058-6625 Ph: (631) 848-3740 |
| NPI Number | 1467769398 |
|---|---|
| Provider Enumeration Date | 09/14/2010 |
| Last Update Date | 06/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467769398 | NPI | - | NPPES |
| 776635011F | Medicaid | GA | |
| 776635011A | Medicaid | GA | |
| 776635011I | Medicaid | GA | |
| 776635011G | Medicaid | GA | |
| 776635011H | Medicaid | GA | |
| 776635011D | Medicaid | GA | |
| 776635011C | Medicaid | GA | |
| 609202851A | Medicaid | GA | |
| 776635011E | Medicaid | GA | |
| 776635011B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 044-01-850-2 (Georgia) | Primary |
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