Organization
SULLY'S LOVING ADC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA L SULLIVAN (CEO)
(706) 910-2725
Entity
Organization
Contact information
Practice address
129 BAREFIELD DR, HEPHZIBAH, GA 30815-4785
(706) 910-2727
Mailing address
129 BAREFIELD DR, HEPHZIBAH, GA 30815-4785
(706) 910-2725
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457072324
—
GA
Enumeration date
03/02/2023
Last updated
03/02/2023
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