Organization
LE'GLEN PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLYNDA M ETCHISON (PROVIDER)
(404) 963-1599
Entity
Organization
Contact information
Practice address
2490 BOULDER SPRINGS PT, ELLENWOOD, GA 30294-1762
(404) 963-1599
Mailing address
2490 BOULDER SPRINGS PT, ELLENWOOD, GA 30294-1762
(404) 963-1599
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCH008098
GA
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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