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General NPI Number Information
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NPI Number | 1497497986
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Entity Type | Organization
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Legal Business Name | 1230 ENTERPRISES
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 100 HARTSFIELD CENTER PKWY STE 500
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City | ATLANTA
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State | GA
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Zip | 30354-1377
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Country | US
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Telephone | 678-975-5886
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Fax |
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Provider Business Mailing Address
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Address Line | 533 EAST ST
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City | BROCKTON
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State | MA
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Zip | 02302-4455
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Country | US
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Telephone | 617-388-1674
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAMON HOUSTON
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Credential |
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Telephone | 678-975-5886
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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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