# LIFE TIME HOME CARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** life time home care services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326223702
- **Authorized official:** MRS. BETTY KELLY LEE ETC (DIRECTOR/OWENER)
- **Authorized official phone:** (678) 523-8082

## Contact information

- **Practice address:** 577 PINE VALLEY DR, SUITE 200, POWDER SPRINGS, GA 30127-6629
- **Practice address phone:** (678) 523-8082
- **Practice address fax:** (678) 567-5246
- **Mailing address:** 577 PINE VALLEY DR, SUITE 200, POWDR SPRING, GA 30127
- **Mailing address phone:** (678) 523-8082
- **Mailing address fax:** (675) 567-5246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 110-R-0225 | GA | Yes |
| 261QH0100X | Health Service Clinic/Center | 110R0225 | GA | — |

## Other

- **Enumeration date:** 01/04/2008
- **Last updated:** 01/04/2008