Organization
A SUPERIOR CHOICE MEDICAL STAFFING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN LACEY (CEO)
(678) 464-1397
Entity
Organization
Contact information
Practice address
5881 GLENRIDGE DR, SUITE 140, ATLANTA, GA 30328-5301
(404) 257-1608
(404) 257-1609
Mailing address
5881 GLENRIDGE DR, SUITE 140, ATLANTA, GA 30328-5301
(404) 257-1608
(404) 257-1609
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
060-R-0154
GA
253Z00000X
In Home Supportive Care Agency
Primary
060-R-0154
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413665791A
—
GA
Enumeration date
02/02/2015
Last updated
06/12/2015
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