# A SUPERIOR CHOICE MEDICAL STAFFING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629468392
- **Authorized official:** MR. BRIAN LACEY (CEO)
- **Authorized official phone:** (678) 464-1397

## Contact information

- **Practice address:** 5881 GLENRIDGE DR, SUITE 140, ATLANTA, GA 30328-5301
- **Practice address phone:** (404) 257-1608
- **Practice address fax:** (404) 257-1609
- **Mailing address:** 5881 GLENRIDGE DR, SUITE 140, ATLANTA, GA 30328-5301
- **Mailing address phone:** (404) 257-1608
- **Mailing address fax:** (404) 257-1609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 060-R-0154 | GA | — |
| 253Z00000X | In Home Supportive Care Agency | 060-R-0154 | GA | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 06/12/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 413665791A | — | GA |