Healthcare Provider Details

I. General information

NPI: 1902236284
Provider Name (Legal Business Name): COMPASSIONATE HANDS PERSONAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 DEEP SOUTH RD
SENOIA GA
30276
US

IV. Provider business mailing address

PO BOX 741373
RIVERDALE GA
30274-1325
US

V. Phone/Fax

Practice location:
  • Phone: 404-275-6744
  • Fax: 770-991-9768
Mailing address:
  • Phone: 404-275-6744
  • Fax: 770-991-9768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: PRISCILLA JANE THOMPSON
Title or Position: MANAGER
Credential:
Phone: 404-274-6744