Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

363L00000X

Organization Nursing Facility/Intermediate Care Facility · NPI 1760856645

363L00000X is a Nursing Facility/Intermediate Care Facility in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2015.

Licensed in
GA
In the registry since
2015

Practice location Address checks out

2171 Peachtree Rd NE Apt 306
Atlanta, GA 30309-6300
Phone: (678) 464-9424
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nursing Facility/Intermediate Care Facility (primary) Taxonomy 313M00000X · Licence 363L00000X (GA)

Record details

NPI number1760856645
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anetha Peterson — Nurse Practitioner · (678) 464-9424
NPI enumeratedNovember 16, 2015
Last updated in NPPESNovember 16, 2015
Mailing address2171 Peachtree Rd Ne, Apt 306, Atlanta, GA 30309-6300

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