# THE CALLA LILY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Social Wellness Club
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679925838
- **Authorized official:** DORESHA K BANKS (FOUNDER)
- **Authorized official phone:** (856) 625-1741

## Contact information

- **Practice address:** 670 PATHWOOD LN, STOCKBRIDGE, GA 30281-7787
- **Practice address phone:** (856) 625-1741
- **Mailing address:** 670 PATHWOOD LN, STOCKBRIDGE, GA 30281-7787
- **Mailing address phone:** (856) 625-1741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 13131 | NC | Yes |

## Other

- **Enumeration date:** 07/11/2016
- **Last updated:** 07/11/2016