Organization
SOVEREIGN HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACHELL M MENSING MS, OTR/L (CEO/PRESIDENT)
(360) 989-6710
Entity
Organization
Contact information
Practice address
6015 WATERS EDGE TRL, ROSWELL, GA 30075-8275
(360) 989-6710
Mailing address
6015 WATERS EDGE TRL, ROSWELL, GA 30075-8275
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
004876
GA
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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