Provider Demographics
NPI:1588207971
Name:LILIUMCARE LLC
Entity Type:Organization
Organization Name:LILIUMCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-213-3356
Mailing Address - Street 1:3108 PIEDMONT RD NE STE 120
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2533
Mailing Address - Country:US
Mailing Address - Phone:470-737-3681
Mailing Address - Fax:470-655-2951
Practice Address - Street 1:3108 PIEDMONT RD NE STE 120
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2533
Practice Address - Country:US
Practice Address - Phone:470-737-3681
Practice Address - Fax:470-655-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty