Healthcare Provider Details

I. General information

NPI: 1447167424
Provider Name (Legal Business Name): CHELLA CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 MICHELLE LN
HIRAM GA
30141
US

IV. Provider business mailing address

89 MICHELLE LN
HIRAM GA
30141
US

V. Phone/Fax

Practice location:
  • Phone: 354-261-3646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MARY MOSCHELLA
Title or Position: MANAGER
Credential:
Phone: 354-621-6125