Lifetime Personal Care Home, LNC.

Organization Active NPI Community/Behavioral Health Agency · Auburn, GA

NPI 1235537499 · NPPES record last updated Dec 19, 2014

Key facts

NPI
1235537499
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
067-R-0355 (GA)
Legal business name
LIFETIME PERSONAL CARE HOME, LNC.
Practice address
40 Auburn Park Drive
Auburn, GA 30011
Phone
(678) 985-0456
NPI assigned
Dec 19, 2014
Organization subpart
No

Authorized official

Name
Adedoyin Victoria Ayeni, ASSOCAITE
Title
Administrator
Phone
(678) 985-0456

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lifetime Health Care Service LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 067-R-0355 GA Yes

Addresses

Primary practice location

40 Auburn Park Drive
Auburn, GA 30011

Mailing address

40 Auburn Park Dr
Auburn, GA 30011-3643
Phone (678) 985-0456

Other providers in Auburn, GA

All providers in Auburn, GA · Community/Behavioral Health Agency in Georgia

Sources for this page

Verify at the official NPI Registry.