Organization
QUEENAIR TLC HOME SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIRQUETTA SHUVONNE HOLDEN (OWNER)
(678) 789-1116
Entity
Organization
Contact information
Practice address
2072 BEN HILL RD, EAST POINT, GA 30344-4124
(470) 302-3983
Mailing address
2072 BEN HILL RD, EAST POINT, GA 30344-4124
(470) 302-3983
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
253Z00000X
—
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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