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Organization
BLACKLAND HOME CARE, LLC
Active
Organization
BLACKLAND HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN P HANNAN (DIRECTOR)
(404) 518-9522
Entity
Organization
Contact information
Practice address
177 ENNISBROOK DR SE, SMYRNA, GA 30082-2451
(678) 823-8155
(678) 823-8156
Mailing address
177 ENNISBROOK DR SE, SMYRNA, GA 30082-2451
(678) 823-8155
(678) 823-8156
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN 188675
GA
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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