Le'Glen Personal Care Home

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

PCH008098 Issued in GA

Legal business name

LE'GLEN PERSONAL CARE HOME

Practice address

2490 Boulder Springs PT
Ellenwood, GA 30294-1762

Phone

(404) 963-1599

NPI assigned

Aug 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Glynda M Etchison

Title

Provider

Phone

(404) 963-1599

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1053669986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 BOULDER SPRINGS PT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941762",
            "telephone_number": "404-963-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 BOULDER SPRINGS PT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941762",
            "telephone_number": "404-963-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE'GLEN PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "ETCHISON",
        "authorized_official_first_name": "GLYNDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "404-963-1599",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "PCH008098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyambura Kuria
• Linh Man La
• Latonya M Andrews
• Marc Lawson
• Chezann Lawton, APRN
• Derrick Andre Leach
• Beverly L Leavy, CNA
• Shelia Leek, PHLEBOTOMIST
• Terrilyn D Lemons, APRNP
• Claudea Antonette Lewis-Comrie

• All providers in Ellenwood, GA
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.