Healthcare Provider Details

I. General information

NPI: 1497389035
Provider Name (Legal Business Name): CARTER CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2020
Last Update Date: 02/22/2020
Certification Date: 02/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 SPARROW WOOD LN SW
MARIETTA GA
30008-7661
US

IV. Provider business mailing address

1631 SPARROW WOOD LN SW
MARIETTA GA
30008-7661
US

V. Phone/Fax

Practice location:
  • Phone: 678-531-4315
  • Fax:
Mailing address:
  • Phone: 678-531-4315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: LATONYA CARTER
Title or Position: CEO
Credential:
Phone: 678-531-4315