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General NPI Number Information
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NPI Number | 1184519985
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Entity Type | Organization
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Legal Business Name | GOOD LIVING HOME CARE LLC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 4927 WATERROCK RD
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City | ELLENWOOD
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State | GA
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Zip | 30294-6707
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Country | US
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Telephone | 404-844-8270
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Fax |
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Provider Business Mailing Address
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Address Line | 4927 WATERROCK RD
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City | ELLENWOOD
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State | GA
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Zip | 30294-6707
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Country | US
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Telephone | 404-844-8270
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | OSMAN JALLOH
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Credential |
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Telephone | 404-386-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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