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General NPI Number Information
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NPI Number | 1992715411
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Entity Type | Organization
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Legal Business Name | LIVING CENTERS-SOUTHEAST, INC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | ONE RAVINIA DRIVE, SUITE 1250
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City | ATLANTA
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State | GA
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Zip | 30346
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Country | US
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Telephone | 678-443-6772
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Fax | 678-443-7013
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Provider Business Mailing Address
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Address Line | ONE RAVINIA DRIVE, SUITE 1250
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City | ATLANTA
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State | GA
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Zip | 30346
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Country | US
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Telephone | 678-443-6772
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Fax | 678-443-7013
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Authorized Official
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Title or Position | SVP
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Name | DEVIN M EHRLICH
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Credential |
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Telephone | 678-443-6772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH2516
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALF535999
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License Number State | VA
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