Healthcare Provider Details

I. General information

NPI: 1548714843
Provider Name (Legal Business Name): AMAZING CARE AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 SCENIC HWY SUITE 100
LAWRENCEVILLE GA
30046-5603
US

IV. Provider business mailing address

223 SCENIC HWY SUITE 100
LAWRENCEVILLE GA
30046-5603
US

V. Phone/Fax

Practice location:
  • Phone: 678-789-4629
  • Fax:
Mailing address:
  • Phone: 678-789-4629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateGA

VIII. Authorized Official

Name: MS. RHODA PAPPOE
Title or Position: OWNER
Credential:
Phone: 678-789-4629