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Organization

LIFE CARE & WISDOM CENTER PERSONAL CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FLOYD BILLUPS (CEO)
(708) 256-0698
Entity
Organization

Contact information

Practice address
5637 LA FLEUR TRL, LITHONIA, GA 30038-2846
(708) 256-0698
Mailing address
4515 SUNLIGHT CT, LILBURN, GA 30047-4585
(708) 256-0698

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BL19-000371
BUSINESS LICENSE
GA
Enumeration date
10/23/2019
Last updated
10/23/2019
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