# OLISTELL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Healthcare Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841269768
- **Authorized official:** MR. BENJAMIN O. DAVIES (CEO)
- **Authorized official phone:** (770) 719-5229

## Contact information

- **Practice address:** 290 HIGHWAY 314, SUITE C, FAYETTEVILLE, GA 30214-7813
- **Practice address phone:** (770) 719-8454
- **Practice address fax:** (770) 719-2532
- **Mailing address:** 290 HIGHWAY 314, SUITE C, FAYETTEVILLE, GA 30214-7813
- **Mailing address phone:** (770) 719-8454
- **Mailing address fax:** (770) 719-2532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 056-R-0004 | GA | Yes |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 08/22/2020