Provider Demographics
NPI:1427681816
Name:PRUDENT SENIOR SERVICES OF GEORGIA
Entity type:Organization
Organization Name:PRUDENT SENIOR SERVICES OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:WOOIYI
Authorized Official - Middle Name:
Authorized Official - Last Name:YIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-612-1388
Mailing Address - Street 1:3850 HOLCOMB BRIDGE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-5292
Mailing Address - Country:US
Mailing Address - Phone:770-454-7979
Mailing Address - Fax:
Practice Address - Street 1:3860 HOLCOMB BRIDGE RD
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092
Practice Address - Country:US
Practice Address - Phone:770-454-7979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRUDENT SENIOR SERVICES OF GEORGIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-13
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care