Individual
ALEXIS LILLIE VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 S LAKE DR, COVINGTON, GA 30016-4795
(678) 481-1439
Mailing address
625 S LAKE DR, COVINGTON, GA 30016-4795
(678) 481-1439
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
0030076692
GA
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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