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Organization

LIFETIME PERSONAL CARE HOME, LNC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADEDOYIN VICTORIA AYENI ASSOCAITE (ADMINISTRATOR)
(678) 985-0456
Entity
Organization

Contact information

Practice address
40 AUBURN PARK DRIVE, AUBURN, GA 30011
(678) 985-0456
Mailing address
40 AUBURN PARK DR, AUBURN, GA 30011-3643
(678) 985-0456

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
067-R-0355
GA

Other

Enumeration date
12/19/2014
Last updated
12/19/2014
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