Healthcare Provider Details

I. General information

NPI: 1972223055
Provider Name (Legal Business Name): CAAP HOME VISITS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 LANGFORD DR BLDG 100-103
WATKINSVILLE GA
30677-7302
US

IV. Provider business mailing address

1181 LANGFORD DR BLDG 100-103
WATKINSVILLE GA
30677-7302
US

V. Phone/Fax

Practice location:
  • Phone: 706-208-1990
  • Fax:
Mailing address:
  • Phone: 706-208-1990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WENDY GILBERT
Title or Position: VICE PRESIDENT OF POPULATION HEALTH
Credential:
Phone: 706-208-1990