Organization
ALEGNA ALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA JACOBS JORDAN R.N. (OWNER ADMINISTRATOR)
(678) 992-2677
Entity
Organization
Contact information
Practice address
5696 PEACHTREE PARKWAY, SUITE A, PEACHTREE CORNERS, GA 30092-2835
(678) 992-2677
Mailing address
PO BOX 1726, TUCKER, GA 30085-1726
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
207287246D
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207287246D
—
GA
Enumeration date
05/08/2017
Last updated
05/08/2017
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