Healthcare Provider Details

I. General information

NPI: 1306386750
Provider Name (Legal Business Name): COMPLETE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 DAWSON RD
ALBANY GA
31707-3851
US

IV. Provider business mailing address

1205 DAWSON RD
ALBANY GA
31707-3851
US

V. Phone/Fax

Practice location:
  • Phone: 229-435-7764
  • Fax:
Mailing address:
  • Phone: 229-435-7764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number047-R-1538
License Number StateGA

VIII. Authorized Official

Name: ZELDA PETERS
Title or Position: ADMINISTRATOR/LAB DIRECTOR
Credential: FNP
Phone: 229-894-7877