Organization
BOSWELLIA CORP
Active
Other names
LAKESIDE HOME HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RORI ELIZABETH CORYATT (CEO,ADMINISTRATOR)
(903) 675-1572
Entity
Organization
Contact information
Practice address
228 N PRAIRIEVILLE ST, ATHENS, TX 75751-2043
(903) 675-1572
(903) 675-1963
Mailing address
228 N PRAIRIEVILLE ST, ATHENS, TX 75751-2043
(903) 675-1572
(903) 675-1963
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
009401
TX
Other
Enumeration date
11/03/2006
Last updated
08/22/2020
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