# DELTA & CHARLEY 3208 LLC

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

## Provider details

- **NPI number:** 1790509859
- **Authorized official:** DAVID LIGHTEN (CEO)
- **Authorized official phone:** (619) 392-7246

## Contact information

- **Practice address:** 3208 JODECO DR, JONESBORO, GA 30236-5324
- **Practice address phone:** (619) 392-7246
- **Mailing address:** 3208 JODECO DR, JONESBORO, GA 30236-5324

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385H00000X | Respite Care | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2024
- **Last updated:** 11/14/2024