Healthcare Provider Details
I. General information
NPI: 1659838571
Provider Name (Legal Business Name): SENSITIVE HOME CARE AGENCY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2019
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2225 MORNING DEW
CONYERS GA
30094
US
IV. Provider business mailing address
2225 MORNING DEW
CONYERS GA
30094
US
V. Phone/Fax
- Phone: 770-648-8296
- Fax: 770-648-7602
- Phone: 770-648-8296
- Fax: 770-648-7602
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251T00000X |
| Taxonomy | PACE Provider Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANDRA
JOAN
CLARKE
Title or Position: OWNER
Credential:
Phone: 404-429-0631