MEDICARE: AT HOME CARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency		GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972753507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME CARE SERVICES

Provider Business Mailing Address
First Line	:	157 TYLER RDG
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30238-5887
Country	:	US
Telephone Number	:	770-210-6889
Fax Number	:

Provider Business Practice Location Address
First Line	:	157 TYLER RDG
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30238-5887
Country	:	US
Telephone Number	:	770-210-6889
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JANICE PERRY
Credential	:
Telephone Number	:	770-210-6889

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	09/18/2008

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Directions to “AT HOME CARE SERVICES ” Practice Location

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