Organization
OLISTELL, INC.
Active
Other names
Southeastern Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN O. DAVIES (CEO)
(770) 719-5229
Entity
Organization
Contact information
Practice address
290 HIGHWAY 314, SUITE C, FAYETTEVILLE, GA 30214-7813
(770) 719-8454
(770) 719-2532
Mailing address
290 HIGHWAY 314, SUITE C, FAYETTEVILLE, GA 30214-7813
(770) 719-8454
(770) 719-2532
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
056-R-0004
GA
Other
Enumeration date
03/14/2006
Last updated
08/22/2020
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