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General NPI Number Information
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NPI Number | 1043605587
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Entity Type | Organization
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Legal Business Name | A GEM OF COMFORT HOME HEALTH SERVICES
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 2073 FREEPORT RD NW
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City | DALTON
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State | GA
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Zip | 30720-6958
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Country | US
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Telephone | 706-712-0118
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Fax | 706-712-0118
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Provider Business Mailing Address
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Address Line | 2073 FREEPORT RD NW
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City | DALTON
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State | GA
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Zip | 30720-6958
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Country | US
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Telephone | 706-712-0118
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Fax | 706-712-0118
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHY P LUMPKIN
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Credential | CNA
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Telephone | 706-712-0118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 0000041282
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 0000041282
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License Number State | GA
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