Healthcare Provider Details
I. General information
NPI: 1306546809
Provider Name (Legal Business Name): DOVES CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/04/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1115 MOUNT ZION RD STE H
MORROW GA
30260-2266
US
IV. Provider business mailing address
1115 MOUNT ZION RD STE H
MORROW GA
30260-2266
US
V. Phone/Fax
- Phone: 770-703-4321
- Fax:
- Phone: 770-703-4321
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KEISHA
JONES GARNER
Title or Position: OWNER
Credential: LPN,CDP
Phone: 773-656-3982