PETLIN DIVERSIFIED SERVICES LLC
NPI 1801056791
Skilled Nursing Facility in Powder Springs, GA

Active since June 13, 2008
2817 LOST LAKES WAY, POWDER SPRINGS, GA 30127(770) 595-8934 Get Directions Write a Review

NPPES record last updated: June 13, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Petlin Diversified Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETLIN DIVERSIFIED SERVICES LLC (NPI 1801056791) is a healthcare organization registered as a skilled nursing facility in Powder Springs, Georgia and active in the NPI registry since June 2008. The organization lists Linda Angela Mbah, Ceo, as its authorized official.

NPPES Registry Identity

NPI1801056791
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePETLIN DIVERSIFIED SERVICES LLC
Location Address2817 LOST LAKES WAYPowder Springs, GA 30127-6018
Mailing Address2817 Lost Lakes WayPowder Springs, GA 30127-6018 · (770) 595-8934
Organization SubpartNo
Authorized OfficialLinda Angela MbahCeo · (770) 595-8934
Enumeration DateJune 13, 2008
NPI 1801056791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in GA · RN155427NP
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
2817 LOST LAKES WAY, Powder Springs, GA 30127

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Petlin Diversified Services LLC's NPI number?

The NPI number for Petlin Diversified Services LLC is 1801056791. It was assigned to this organization in the NPPES registry on June 13, 2008.

Where is Petlin Diversified Services LLC located?

Petlin Diversified Services LLC is located at 2817 Lost Lakes Way, Powder Springs, GA 30127. The listed phone number is (770) 595-8934.

What is Petlin Diversified Services LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Petlin Diversified Services LLC was last updated on June 13, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.