# UNIQUE 403 LLC

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

## Provider details

- **NPI number:** 1689373136
- **Authorized official:** MONIQUE D LEGETTE CNA (MANAGING MEMBER)
- **Authorized official phone:** (470) 871-4840

## Contact information

- **Practice address:** 5303 WALKER CT SW, MABLETON, GA 30126-2207
- **Practice address phone:** (470) 871-4840
- **Mailing address:** PO BOX 961, MABLETON, GA 30126-0961
- **Mailing address phone:** (678) 614-5444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/23/2023
- **Last updated:** 02/23/2023