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General NPI Number Information
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NPI Number | 1083840805
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Entity Type | Organization
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Legal Business Name | TOP OF THE LINE HEALTHCARE
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 4818 MITCHELLS RIDGE DR
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City | ELLENWOOD
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State | GA
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Zip | 30294-6631
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Country | US
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Telephone | 678-289-2487
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Fax | 678-289-2487
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Provider Business Mailing Address
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Address Line | 4818 MITCHELLS RIDGE DR
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City | ELLENWOOD
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State | GA
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Zip | 30294-6631
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Country | US
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Telephone | 678-289-2487
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Fax | 678-289-2487
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MAUREEN SCOTT RICHARDSON
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Credential | REGISTERED NURSE
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Telephone | 678-896-7486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 044-R-0513
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License Number State | GA
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