Provider Demographics
NPI:1821582503
Name:PELAGIE FOUNDATION LTD
Entity type:Organization
Organization Name:PELAGIE FOUNDATION LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIST-LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZAIRE-GANTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-356-6285
Mailing Address - Street 1:2055 GEES MILL RD NE STE 326
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1364
Mailing Address - Country:US
Mailing Address - Phone:470-356-6285
Mailing Address - Fax:
Practice Address - Street 1:2055 GEES MILL RD NE STE 326
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1364
Practice Address - Country:US
Practice Address - Phone:470-356-6285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 171R00000X, 251V00000X, 347C00000X, 320600000X, 253Z00000X, 332B00000X, 261QR0401X, 343900000X, 251B00000X
GA101YP1600X, 174200000X, 177F00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251V00000XAgenciesVoluntary or Charitable
No347C00000XTransportation ServicesPrivate Vehicle
No253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty