Healthcare Provider Details

I. General information

NPI: 1043124167
Provider Name (Legal Business Name): RR3, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 LOST LAKES WAY
POWDER SPRINGS GA
30127-6018
US

IV. Provider business mailing address

PO BOX 163
FAIRBURN GA
30213-0163
US

V. Phone/Fax

Practice location:
  • Phone: 404-539-5708
  • Fax:
Mailing address:
  • Phone: 404-539-5708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LAVONIA R NELSON
Title or Position: MANAGING
Credential:
Phone: 770-940-0658