| Illum Residential Care, Inc. | |
|
625 Moorings Ave Mcdonough GA 30253-5613 | |
| (470) 476-9527 | |
| Not Available |
| Full Name | Illum Residential Care, Inc. |
|---|---|
| Speciality | Home Health |
| Location | 625 Moorings Ave, Mcdonough, Georgia |
| Authorized Official Name and Position | Raven Pittman (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4704769527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illum Residential Care, Inc. 625 Moorings Ave Mcdonough GA 30253-5613 Ph: (470) 476-9527 | Illum Residential Care, Inc. 625 Moorings Ave Mcdonough GA 30253-5613 Ph: (470) 476-9527 |
| NPI Number | 1033943949 |
|---|---|
| Provider Enumeration Date | 09/02/2024 |
| Last Update Date | 09/02/2024 |
| Certification Date | 09/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033943949 | NPI | - | NPPES |
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