Healthcare Provider Details

I. General information

NPI: 1326468497
Provider Name (Legal Business Name): IN LOVING HANDS ADULT DAY & HEALTH,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 SPRING ST
DOUGLASVILLE GA
30134-1891
US

IV. Provider business mailing address

6585 SPRING ST
DOUGLASVILLE GA
30134-1891
US

V. Phone/Fax

Practice location:
  • Phone: 678-653-8725
  • Fax:
Mailing address:
  • Phone: 678-653-8725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1400010688
License Number StateGA

VIII. Authorized Official

Name: BRITTIA CHILDS
Title or Position: OWNER/ADMINISTATOR
Credential:
Phone: 770-688-0753