Provider Demographics
NPI:1023282951
Name:MURIEL'S ASSISTED LIVING LLC
Entity type:Organization
Organization Name:MURIEL'S ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-576-0189
Mailing Address - Street 1:1630 SONYA DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5730
Mailing Address - Country:US
Mailing Address - Phone:678-576-0189
Mailing Address - Fax:770-977-4097
Practice Address - Street 1:2470 WINDY HILL RD SE
Practice Address - Street 2:300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8613
Practice Address - Country:US
Practice Address - Phone:678-576-0189
Practice Address - Fax:770-977-4097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033011931320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities