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NPI 1053103598

NPI 1053103598 : RIVERCESS HEALTH SERVICES, LLC : HOSCHTON, GA

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General NPI Number Information
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    NPI Number           |    1053103598
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    Entity Type          |    Organization 
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    Legal Business Name  |    RIVERCESS HEALTH SERVICES, LLC 
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Dates
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    Enumeration Date     |    05/20/2025
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    Last Update Date     |    05/20/2025
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Provider Practice Location Address
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    Address Line         |    4781 SUMMERTIME LN 
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    City                 |    HOSCHTON
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    State                |    GA
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    Zip                  |    30548-6299
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    Country              |    US
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    Telephone            |    678-599-3006
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4781 SUMMERTIME LN 
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    City                 |    HOSCHTON
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    State                |    GA
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    Zip                  |    30548-6299
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    Country              |    US
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    Telephone            |    678-599-3006
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DELCONTEE  GLEKIAH 
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    Credential           |    RN
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    Telephone            |    678-599-3006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WH0200X
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    Taxonomy Name        |    Home Health Registered Nurse
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    License Number       |    
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    License Number State |    
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