Organization
THE 90 GROUP, LLC
Active
Other names
Astin Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE LEE ELLIS-WILLIAMS QDCP (OWNER)
(770) 790-0012
Entity
Organization
Contact information
Practice address
1800 PHOENIX BLVD STE 400, ATLANTA, GA 30349-5560
(770) 790-0012
(866) 205-6289
Mailing address
1800 PHOENIX BLVD BLDG 400, SUITE 400 #16, COLLEGE PARK, GA 30349
(770) 790-0012
(866) 205-6289
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
110-R-1162
GA
Other
Enumeration date
07/31/2013
Last updated
08/19/2019
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