Provider Demographics
NPI:1003580689
Name:RELIANCE POST-OP LLC
Entity Type:Organization
Organization Name:RELIANCE POST-OP LLC
Other - Org Name:RELIANCE POST-OP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:OMOBOLA
Authorized Official - Last Name:SANNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-431-6461
Mailing Address - Street 1:2488 IRWELL WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2148
Mailing Address - Country:US
Mailing Address - Phone:678-431-6461
Mailing Address - Fax:
Practice Address - Street 1:2488 IRWELL WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2148
Practice Address - Country:US
Practice Address - Phone:678-431-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000OtherN/A