Organization
FIRST LOVE PERSONAL CARE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CELESTA CAROL LISENBEE (PRESIDENT/OWNER)
(706) 533-5469
Entity
Organization
Contact information
Practice address
2403 WRIGHTSBORO RD, AUGUSTA, GA 30904-6201
(706) 737-2661
(706) 737-2662
Mailing address
2403 WRIGHTSBORO RD, AUGUSTA, GA 30904-6201
(706) 737-2661
(706) 737-2662
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
121014269
GA
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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