Provider Demographics
NPI:1932977204
Name:SKILLED NURSING SOLUTIONS LLC
Entity Type:Organization
Organization Name:SKILLED NURSING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-452-7176
Mailing Address - Street 1:4714 LIONSHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2279
Mailing Address - Country:US
Mailing Address - Phone:404-452-7176
Mailing Address - Fax:
Practice Address - Street 1:4714 LIONSHEAD CIR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2279
Practice Address - Country:US
Practice Address - Phone:404-452-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty