The Calla Lily LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

13131 Issued in NC

Legal business name

THE CALLA LILY LLC

Practice address

670 Pathwood LN
Stockbridge, GA 30281-7787

Phone

(856) 625-1741

NPI assigned

Jul 11, 2016

Organization subpart

No

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

Authorized official

Name

Doresha K Banks

Title

Founder

Phone

(856) 625-1741

Specialties & licenses 1

Addresses

Other names 1

• The Social Wellness Club Doing business as

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1679925838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PATHWOOD LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817787",
            "telephone_number": "856-625-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PATHWOOD LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817787",
            "telephone_number": "856-625-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CALLA LILY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "DORESHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "856-625-1741"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "13131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Social Wellness Club",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Stockbridge, GA
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• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.