Petlin Diversified Services LLC
NPI #1801056791 in Powder Springs, Georgia
Provider Information
- NPI Number
- 1801056791
- Entity Type
- Organization
- Organization Name
- Petlin Diversified Services LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jun 13, 2008
- Last Updated
- Jun 13, 2008
Practice Location
- Address
- 2817 LOST LAKES WAY
- City
- Powder Springs
- State
- Georgia
- ZIP Code
- 30127-6018
- Phone
- (770) 595-8934
Authorized Official
- Name
- MRS. LINDA ANGELA MBAH, NP
- Title
- CEO
- Phone
- (770) 595-8934
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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