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WISE CHOICE RESIDENTIAL
NPI 1720319981
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Conyers, GA

Active since January 27, 2010
1040 LAKE HAYNES DR NE, CONYERS, GA 30012(770) 365-0578(770) 679-4143 Get Directions Write a Review

NPPES record last updated: January 27, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wise Choice Residential NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WISE CHOICE RESIDENTIAL (NPI 1720319981) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Conyers, Georgia and active in the NPI registry since January 2010. The organization lists Fernando Leroy Favors, Owner, as its authorized official.

NPPES Registry Identity

NPI1720319981
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameWISE CHOICE RESIDENTIAL
Location Address1040 LAKE HAYNES DR NEConyers, GA 30012-1519
Mailing Address1040 Lake Haynes Dr NeConyers, GA 30012-1519 · (770) 365-0578 · Fax (770) 679-4143
Phone(770) 365-0578
Fax(770) 679-4143
Organization SubpartNo
Authorized OfficialFernando Leroy FavorsOwner · (678) 409-5882
Enumeration DateJanuary 27, 2010
✔ NPI 1720319981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in GA · 621960416A
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
1040 LAKE HAYNES DR NE, Conyers, GA 30012
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wise Choice Residential's NPI number?

The NPI number for Wise Choice Residential is 1720319981. It was assigned to this organization in the NPPES registry on January 27, 2010.

Where is Wise Choice Residential located?

Wise Choice Residential is located at 1040 Lake Haynes Dr NE, Conyers, GA 30012. The listed phone number is (770) 365-0578.

What is Wise Choice Residential's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Wise Choice Residential was last updated on January 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.