Organization
POST ACUTE CARE LEADERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER JUSTISS (CONTROLLER)
(678) 593-3332
Entity
Organization
Contact information
Practice address
156 PINE KNOLL DR, CARROLLTON, GA 30117-2451
(678) 593-3332
(678) 868-1584
Mailing address
925 N POINT PKWY STE 425, ALPHARETTA, GA 30005-5200
(678) 593-3332
(678) 868-1584
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/29/2018
Last updated
06/01/2022
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