Provider Demographics
NPI:1336802818
Name:LAUTURE, ROLANDE VALCOURT
Entity Type:Individual
Prefix:
First Name:ROLANDE
Middle Name:VALCOURT
Last Name:LAUTURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3868 SUMMER KITCHEN WAY
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-7822
Mailing Address - Country:US
Mailing Address - Phone:770-837-8569
Mailing Address - Fax:
Practice Address - Street 1:3868 SUMMER KITCHEN WAY
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-7822
Practice Address - Country:US
Practice Address - Phone:770-837-8569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health