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General NPI Number Information
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NPI Number | 1013531383
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Entity Type | Organization
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Legal Business Name | PRESCOTT HEALTHCARE LLC
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 889 1/2 RALPH DAVID ABERNATHY BLVD SW
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City | ATLANTA
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State | GA
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Zip | 30310-1800
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Country | US
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Telephone | 404-883-3302
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Fax | 678-515-0876
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Provider Business Mailing Address
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Address Line | 889 1/2 RALPH DAVID ABERNATHY BLVD SW
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City | ATLANTA
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State | GA
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Zip | 30310-1800
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Country | US
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Telephone | 404-883-3302
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LATEEFAH AZIZ
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Credential |
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Telephone | 404-883-3302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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