Organization
LIVING WELL PERSONAL CARE HOME LLC
Active
Other names
Living Well Personal Care Home LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGENETTE YVONNE AGAMA (OWNER/ADMINISTRATOR)
(678) 829-3499
Entity
Organization
Contact information
Practice address
10903 WHEELER TRCE, HAMPTON, GA 30228-6461
(678) 829-3499
(678) 829-3499
Mailing address
10903 WHEELER TRCE, HAMPTON, GA 30228-6461
(678) 829-3499
(678) 829-3499
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
03/09/2023
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