Healthcare Provider Details

I. General information

NPI: 1609117779
Provider Name (Legal Business Name): ANOINTED HANDS HOME CARE AGENCY ,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 BROWNLEE RD
JACKSON GA
30233-5903
US

IV. Provider business mailing address

2151 BROWNLEE RD
JACKSON GA
30233-5903
US

V. Phone/Fax

Practice location:
  • Phone: 678-218-8114
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CECELIA BUCKNER
Title or Position: CEO
Credential:
Phone: 678-218-8114