Organization
ATLANTA PEDIATRIC HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCELLA GRANT (OWNER)
(678) 431-5483
Entity
Organization
Contact information
Practice address
320 LANIER AVE W STE 259, FAYETTEVILLE, GA 30214-1600
(770) 250-7477
Mailing address
320 LANIER AVE W STE 259, FAYETTEVILLE, GA 30214-1600
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003227891A
—
GA
Enumeration date
09/26/2019
Last updated
10/30/2022
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