Organization
LIVE EMERGE AND PERSEVERE LLC
Active
Organization
LIVE EMERGE AND PERSEVERE LLC
Active
Other names
LEAP Private Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LASHANDA NICOLE WASHINGTON MPH (OWNER)
(850) 284-3245
Entity
Organization
Contact information
Practice address
2169 FOREST RIDGE RD SE, ATLANTA, GA 30316-4973
(678) 638-0460
Mailing address
2169 FOREST RIDGE RD SE, ATLANTA, GA 30316-4973
(678) 638-0460
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHCP011213
PRIVATE HOMECARE PROVIDER PERMIT
GA
Enumeration date
10/05/2021
Last updated
10/05/2021
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