Organization
KINGS PERSONAL KARE FACILITY GRP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE SPEARS (EXECUTIVE DIRECTOR)
(678) 472-3015
Entity
Organization
Contact information
Practice address
111 ELIZABETH WAY, ELLENWOOD, GA 30294-2820
(678) 869-5464
(678) 583-1496
Mailing address
111 ELIZABETH WAY, ELLENWOOD, GA 30294-2820
(678) 869-5464
(678) 583-1496
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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