Organization
LEARN NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LADAWN J HALL (DIRECTOR CLINICAL SERVICES)
(678) 701-5180
Entity
Organization
Contact information
Practice address
2131 PACE ST, COVINGTON, GA 30014
(678) 701-5180
(678) 712-9979
Mailing address
2131 PACE ST, COVINGTON, GA 30014
(678) 701-5180
(678) 712-9979
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
080871
GA
291U00000X
Clinical Medical Laboratory
Primary
025
GA
332B00000X
Durable Medical Equipment & Medical Supplies
080870
GA
Other
Enumeration date
09/18/2009
Last updated
09/18/2009
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