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Organization

MIND BODY AND SOUL HOMECARE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KALIA C LUCAS-SMITH (NURSE)
(404) 839-2107
Entity
Organization

Contact information

Practice address
565 HANK AARON DR SW APT 5090, ATLANTA, GA 30312-2889
(404) 839-2107
Mailing address
565 HANK AARON DR SW APT 5090, ATLANTA, GA 30312-2889
(404) 839-2107

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
163WW0000X
Wound Care Registered Nurse
164W00000X
Licensed Practical Nurse
251J00000X
Nursing Care Agency
Primary
363L00000X
Nurse Practitioner
374U00000X
Home Health Aide
376K00000X
Nurse's Aide

Other

Enumeration date
06/17/2024
Last updated
06/17/2024
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