Provider Demographics
NPI:1992430292
Name:NICELY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:NICELY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ACHANGWO
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:LEKEAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-308-5012
Mailing Address - Street 1:1599 SCHOOL HOUSE RUN
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7805
Mailing Address - Country:US
Mailing Address - Phone:706-308-5012
Mailing Address - Fax:
Practice Address - Street 1:1599 SCHOOL HOUSE RUN
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7805
Practice Address - Country:US
Practice Address - Phone:706-308-5012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health