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General NPI Number Information
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NPI Number | 1588945539
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Entity Type | Organization
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Legal Business Name | LOVING HOME CARE OF GEORGIA
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Dates
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Enumeration Date | 09/05/2011
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Last Update Date | 09/05/2011
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Provider Practice Location Address
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Address Line | 790 INDIAN TRAIL LILBURN RD NW SUITE # B-103
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City | LILBURN
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State | GA
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Zip | 30047-3724
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Country | US
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Telephone | 770-931-7781
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Fax | 770-931-7781
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Provider Business Mailing Address
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Address Line | 790 INDIAN TRAIL LILBURN RD NW SUITE # B-103
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City | LILBURN
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State | GA
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Zip | 30047-3724
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Country | US
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Telephone | 770-931-7781
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Fax | 770-931-7781
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. YASIN SAYA
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Credential |
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Telephone | 617-320-3458
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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 | 067-R-0820
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License Number State | GA
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