OrganizationActive
Big Mama House
NPI 1659752491 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Stone Mountain, GA
Provider details
- NPI number
- 1659752491
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Hanniyah Abdul Aziz, Ceo/Owner(404) 538-6074
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Practice location
707 Pennybrook Ln
Stone Mountain, GA 30087-5918
Phone: (404) 538-6074
Approximate (ZIP-level) locationGet directions
Mailing address
707 Pennybrook Ln
Stone Mountain, GA 30087-5918
Registry dates
- Enumerated
- 2015-06-17
- Last updated
- 2015-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.