Organization
N/A AT PRESENT TIME, WILL BE WORKING CONTRACTPRIVATEDUTY
Active
Organization
N/A AT PRESENT TIME, WILL BE WORKING CONTRACTPRIVATEDUTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LISA POTTS CERTIFIED NURSING AS (CNA)
(706) 333-9369
Entity
Organization
Contact information
Practice address
401A BOULEVARD, 401ABOULEVARD, LAGRANGE, GA 30240-3009
(706) 333-9369
Mailing address
401A BOULEVARD, 401ABOULEVARD, LAGRANGE, GA 30240-3009
(706) 333-9369
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
CN0000047840
GA
376K00000X
Nurse's Aide
CN0000047840
AL
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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