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General NPI Number Information
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NPI Number | 1033992409
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Entity Type | Organization
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Legal Business Name | BACK TO THE BASICS NURSING SERVICES, LLC
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Dates
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Enumeration Date | 08/17/2023
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 179 GOODALL WOODS DR
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City | MACON
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State | GA
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Zip | 31216-6498
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Country | US
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Telephone | 478-796-3858
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Fax |
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Provider Business Mailing Address
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Address Line | 179 GOODALL WOODS DR
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City | MACON
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State | GA
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Zip | 31216-6498
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Country | US
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Telephone | 478-796-3858
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MISS LAMONICA CARSON
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Credential | LPN
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Telephone | 478-796-3858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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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 | 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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