Healthcare Provider Details

I. General information

NPI: 1689223588
Provider Name (Legal Business Name): CAREBRAND HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LOBLOLLY LN
ALBANY GA
31721-7724
US

IV. Provider business mailing address

106 LOBLOLLY LN
ALBANY GA
31721-7724
US

V. Phone/Fax

Practice location:
  • Phone: 229-338-7778
  • Fax: 229-338-7774
Mailing address:
  • Phone: 229-338-7778
  • Fax: 229-338-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAWNDRA LASTER DANIEL
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 678-480-7915