Healthcare Provider Details

I. General information

NPI: 1760754113
Provider Name (Legal Business Name): CATER HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 VETERANS DR STE 3A
CONYERS GA
30012-5258
US

IV. Provider business mailing address

1424 VETERANS DR STE 3A
CONYERS GA
30012-5258
US

V. Phone/Fax

Practice location:
  • Phone: 770-648-7532
  • Fax: 678-806-5555
Mailing address:
  • Phone: 770-648-7532
  • Fax: 678-806-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DEBRAH ROBERTS
Title or Position: OWNER
Credential:
Phone: 770-648-7532