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General NPI Number Information
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NPI Number | 1972376200
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Entity Type | Organization
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Legal Business Name | LISTENING HANDS CARE SERVICES, LLC
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 412 CONYERS RD
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City | LOGANVILLE
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State | GA
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Zip | 30052-2650
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Country | US
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Telephone | 770-778-1702
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Fax |
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Provider Business Mailing Address
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Address Line | 412 CONYERS RD
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City | LOGANVILLE
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State | GA
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Zip | 30052-2650
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Country | US
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Telephone | 770-778-1702
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Fax |
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Authorized Official
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Title or Position | HOLISTIC REGISTERED NURSE
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Name | LADEIDRA WOOTEN
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Credential | RN
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Telephone | 770-778-1702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number |
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License Number State |
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