Healthcare Provider Details

I. General information

NPI: 1710678339
Provider Name (Legal Business Name): GODWINS FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4945 BAKER PLANTATION WAY
ACWORTH GA
30101-6218
US

IV. Provider business mailing address

4945 BAKER PLANTATION WAY
ACWORTH GA
30101-6218
US

V. Phone/Fax

Practice location:
  • Phone: 404-246-8505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BETHEL GODWINS
Title or Position: CEO
Credential: NP
Phone: 404-246-8505