Organization
LUM PERSONAL CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNIE LUM RN (DIRECTOR/OWNER)
(631) 885-5510
Entity
Organization
Contact information
Practice address
1132 COPPER CREEK DR, CANTON, GA 30114-8178
(631) 885-5510
Mailing address
1132 COPPER CREEK DR, CANTON, GA 30114-8178
(631) 885-5510
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
RN235987
GA
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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