IndividualActive
Andrea Streeter
NPI 1205205473 · Intellectual Disabilities Intermediate Care Facility · Stone Mountain, GA
Provider details
- NPI number
- 1205205473
- Entity type
- Individual
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 044016471 (GA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
439 Watson Bay
Stone Mountain, GA 30087-6195
Phone: (770) 465-6858
Approximate (ZIP-level) locationGet directions
Mailing address
439 Watson Bay
Stone Mountain, GA 30087-6195
Registry dates
- Enumerated
- 2015-09-17
- Last updated
- 2015-09-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.