Organization
TRULY LIVING WELL PCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE CASEY (OWNER)
(678) 451-2890
Entity
Organization
Contact information
Practice address
7078 BETHEL CT, RIVERDALE, GA 30296-2152
(678) 519-4984
Mailing address
326 RIDGE TRL, RIVERDALE, GA 30274-1954
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
031011731
GA
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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