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General NPI Number Information
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NPI Number | 1205031507
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Entity Type | Organization
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Legal Business Name | PARK SPRINGS, LLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 500 SPRINGHOUSE CIR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-6718
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Country | US
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Telephone | 678-684-3036
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Fax | 770-879-7330
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Provider Business Mailing Address
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Address Line | 500 SPRINGHOUSE CIR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-6718
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Country | US
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Telephone | 678-684-3036
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Fax | 770-879-7330
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Authorized Official
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Title or Position | MANAGER
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Name | KEVIN W ISAKSON
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Credential |
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Telephone | 404-932-6552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 044-R-0177
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License Number State | GA
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