| NPI | 1265924740 |
|---|---|
| Former Legal Business Name | LEGACY VINE SENIOR SERVICE INC. |
| Entity Type | Organization |
| Authorized Contact | LUVENIA M YATES Care Manager 470-298-7477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: GA 033-R-1796) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |