=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043124167
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RR3, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2026
-----------------------------------------------------
Last Update Date | 09/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2809 LOST LAKES WAY
-----------------------------------------------------
City | POWDER SPRINGS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30127-6018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-539-5708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 163
-----------------------------------------------------
City | FAIRBURN
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30213-0163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-539-5708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING
-----------------------------------------------------
Name | LAVONIA R NELSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 770-940-0658
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------