Healthcare Provider Details

I. General information

NPI: 1962150557
Provider Name (Legal Business Name): WHITE LILY HEALTH CARE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11680 GREAT OAKS WAY STE 300
ALPHARETTA GA
30022-2459
US

IV. Provider business mailing address

11680 GREAT OAKS WAY STE 300
ALPHARETTA GA
30022-2459
US

V. Phone/Fax

Practice location:
  • Phone: 404-729-4190
  • Fax:
Mailing address:
  • Phone: 404-729-4190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. OREZIME FLORENCE JOCKEY
Title or Position: ADMINISTRATOR
Credential: DIRECTOR
Phone: 404-729-4190