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General NPI Number Information
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NPI Number | 1023830700
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Entity Type | Organization
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Legal Business Name | CARECHOICE GA LLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 3372 PEACHTREE RD NE STE 115
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City | ATLANTA
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State | GA
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Zip | 30326-1963
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Country | US
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Telephone | 215-277-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 785 ADMIRALTY PARADE E
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City | NAPLES
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State | FL
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Zip | 34102-7804
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Country | US
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Telephone | 267-226-8392
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ARSEN USTAYEV
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Credential |
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Telephone | 215-277-0000
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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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