Organization
PROFESSIONAL NURSING AND SUPPORT SERVICES LLC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LASHANDA L WILLIAMS REGISTERED NURSE (ADMINISTRATOR)
(229) 559-4607
Entity
Organization
Contact information
Practice address
7626 ENOCH LAKE CIR, LAKE PARK, GA 31636-3906
(229) 559-4607
Mailing address
7626 ENOCH LAKE CIR, LAKE PARK, GA 31636-3906
(229) 559-4607
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
RN210699
GA
253Z00000X
In Home Supportive Care Agency
Primary
092-R-0897
GA
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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