Organization
EXCELSIOR PRIVATE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIETH VERINICA PERRY (ADMINISTRATOR)
(770) 655-8360
Entity
Organization
Contact information
Practice address
270 TRELAWNEY DR, COVINGTON, GA 30016-6819
(770) 385-8194
Mailing address
270 TRELAWNEY DR, COVINGTON, GA 30016-6819
(770) 385-8194
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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