Organization
BONELL ELDERLY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONITA AGNES CHARLES RN (DIRECTOR)
(678) 565-0574
Entity
Organization
Contact information
Practice address
205 DAVID LARSEN DR, STOCKBRIDGE, GA 30281
(678) 565-0574
(678) 565-0574
Mailing address
205 DAVID LARSEN DR, STOCKBRIDGE, GA 30281
(678) 565-0574
(678) 565-0574
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN187342
GA
Other
Enumeration date
01/23/2008
Last updated
06/20/2008
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