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General NPI Number Information
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NPI Number | 1225789563
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Entity Type | Organization
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Legal Business Name | LAMOUR HOME CARE LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 1630 PEACHTREE INDUSTRIAL BLVD APT 1322
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City | SUWANEE
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State | GA
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Zip | 30024-5580
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Country | US
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Telephone | 470-704-9795
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Fax | 470-704-9042
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Provider Business Mailing Address
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Address Line | 6006 APPLE GROVE RD
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City | BUFORD
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State | GA
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Zip | 30519-3416
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Country | US
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Telephone | 470-655-9710
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Fax |
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Authorized Official
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Title or Position | ADMIN/DIR
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Name | KENNETREIUS RUSSELL
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Credential |
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Telephone | 470-655-9710
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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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