# CARE OF LATRELLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174067276
- **Authorized official:** KIMBERLY DAVIS (CREDENTIALING SPECIALISTS)
- **Authorized official phone:** (912) 484-3879

## Contact information

- **Practice address:** 127 WAVERLY WAY, SAVANNAH, GA 31407-5032
- **Practice address phone:** (912) 220-8105
- **Mailing address:** 127 WAVERLY WAY, SAVANNAH, GA 31407-5032
- **Mailing address phone:** (912) 220-8105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/07/2016
- **Last updated:** 12/07/2016