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Organization
PROFESSIONAL NURSING AND SUPPORT SERVICES LLC
Active
Organization
PROFESSIONAL NURSING AND SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LASHANDA LEATRICE WILLIAMS RN (ADMINISTRATOR/OWNER)
(229) 375-4635
Entity
Organization
Contact information
Practice address
7626 ENOCH LAKE CIR, LAKE PARK, GA 31636-3906
(229) 375-4635
Mailing address
7626 ENOCH LAKE CIRCLE, LAKE PARK, GA 31636
(229) 375-4635
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
092-R-0897
GA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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