Living Well Personal Care Home LLC

NPI #1134829567 in Hampton, Georgia

Provider Information

NPI Number: 1134829567
Entity Type: Organization
Organization Name: Living Well Personal Care Home LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 6, 2023
Last Updated: Mar 9, 2023

Practice Location

Address: 10903 WHEELER TRCE
City: Hampton
State: Georgia
ZIP Code: 30228-6461
Phone: (678) 829-3499

Authorized Official

Name: MRS. ANGENETTE YVONNE AGAMA
Title: OWNER/ADMINISTRATOR
Phone: (678) 829-3499

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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