Healthcare Provider Details

I. General information

NPI: 1750290706
Provider Name (Legal Business Name): PERSONAL CARE HOME SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 RED MAPLE WAY
COLUMBUS GA
31904-2711
US

IV. Provider business mailing address

1026 RED MAPLE WAY
COLUMBUS GA
31904-2711
US

V. Phone/Fax

Practice location:
  • Phone: 706-593-2934
  • Fax:
Mailing address:
  • Phone: 706-593-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL WARD
Title or Position: OWNER
Credential:
Phone: 706-593-2934