Provider Demographics
NPI:1073234134
Name:LEMON JUICE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:LEMON JUICE HEALTHCARE SERVICES
Other - Org Name:LEMON JUICE HEALTHCARE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CNA/MED TECH/PROXY CARE-CEOO
Authorized Official - Prefix:
Authorized Official - First Name:VONITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISIDORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-227-1257
Mailing Address - Street 1:2817 JAMES HENRY DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7553
Mailing Address - Country:US
Mailing Address - Phone:404-542-6450
Mailing Address - Fax:
Practice Address - Street 1:1980 PADGETT DR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1864
Practice Address - Country:US
Practice Address - Phone:404-542-6450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEMON JUICE HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-07
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No283X00000XHospitalsRehabilitation Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility