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Organization
STELLA GROVE HEALTH LLC
Active
Organization
STELLA GROVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE DEVON STEWART (ADMINISTRATOR - OWNER)
(404) 759-6625
Entity
Organization
Contact information
Practice address
321 THOROUGHBRED LN, EVANS, GA 30809-4107
(404) 759-6625
Mailing address
321 THOROUGHBRED LN, EVANS, GA 30809-4107
(404) 759-6625
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
311ZA0620X
Adult Care Home Facility
—
NULL
Other
Enumeration date
10/29/2021
Last updated
01/26/2022
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