Healthcare Provider Details

I. General information

NPI: 1467575191
Provider Name (Legal Business Name): FAMILY CARE SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3638 VINEVILLE AVE
MACON GA
31204-1853
US

IV. Provider business mailing address

3638 VINEVILLE AVE
MACON GA
31204-1853
US

V. Phone/Fax

Practice location:
  • Phone: 478-757-9909
  • Fax: 478-757-0195
Mailing address:
  • Phone: 478-757-9909
  • Fax: 478-757-0195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0111R0226
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number0111R0226
License Number StateGA

VIII. Authorized Official

Name: DR. PAMELA ROSHELL
Title or Position: ADMINISTRATOR
Credential: PHD, MSW
Phone: 478-757-9909