Provider Demographics
NPI:1710563366
Name:ALTRUISTIC NURSING AND HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ALTRUISTIC NURSING AND HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FANESHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-593-1130
Mailing Address - Street 1:640 AUTUMN LEAF CIR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8290
Mailing Address - Country:US
Mailing Address - Phone:706-593-1130
Mailing Address - Fax:
Practice Address - Street 1:640 AUTUMN LEAF CIR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8290
Practice Address - Country:US
Practice Address - Phone:706-593-1130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty