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Organization
LITHONIA HEALTHCARE DEVELOPMENT LLC
Active
Organization
LITHONIA HEALTHCARE DEVELOPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN TAYLOR (ADMINISTRATOR)
(214) 484-4610
Entity
Organization
Contact information
Practice address
8035 ERL THORNTON FWY, 456, DALLAS, TX 75228
(214) 484-4610
(214) 602-4077
Mailing address
7414 E GRAND AVE APT 422, DALLAS, TX 75214-4249
(214) 603-3975
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2239956
CLIA WAIVER
TX
Enumeration date
07/03/2020
Last updated
05/09/2023
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