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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