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Organization
MAGENTA BREEZE HOME, INC.
Active
Organization
MAGENTA BREEZE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNETTE TARA VICK (OWNER)
(678) 526-9152
Entity
Organization
Contact information
Practice address
776 KILKENNY CIR, LITHONIA, GA 30058-9026
(678) 526-9152
Mailing address
776 KILKENNY CIR, LITHONIA, GA 30058-9026
(678) 526-9152
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
044-01-493-1
GA
Other
Enumeration date
01/21/2013
Last updated
01/21/2013
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