Organization
LIFE TIME HOME CARE SERVICES
Active
Other names
life time home care services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY KELLY LEE ETC (DIRECTOR/OWENER)
(678) 523-8082
Entity
Organization
Contact information
Practice address
577 PINE VALLEY DR, SUITE 200, POWDER SPRINGS, GA 30127-6629
(678) 523-8082
(678) 567-5246
Mailing address
577 PINE VALLEY DR, SUITE 200, POWDR SPRING, GA 30127
(678) 523-8082
(675) 567-5246
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
110-R-0225
GA
261QH0100X
Health Service Clinic/Center
110R0225
GA
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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