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Organization

LAHORA LIMITED LIABILITY COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OKIKIOLA OLUWABUNMI OGUNBUNMI (CEO)
(678) 516-1702
Entity
Organization

Contact information

Practice address
297 WOOD SAGE DR, RIVERDALE, GA 30274-1869
(678) 516-1702
Mailing address
297 WOOD SAGE DR, RIVERDALE, GA 30274-1869
(678) 516-1702

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Enumeration date
06/09/2023
Last updated
07/27/2023
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