Healthcare Provider Details

I. General information

NPI: 1467522342
Provider Name (Legal Business Name): COMMUNITY HOME NURSING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/10/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4978 HWY 1 S
LYONS GA
30436-5941
US

IV. Provider business mailing address

4978 HWY 1 S
LYONS GA
30436-5941
US

V. Phone/Fax

Practice location:
  • Phone: 912-565-8820
  • Fax: 912-565-0293
Mailing address:
  • Phone: 912-565-8820
  • Fax: 912-565-0293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY TOOMER
Title or Position: ADMINISTRATOR
Credential:
Phone: 912-565-8820