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General NPI Number Information
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NPI Number | 1104171420
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Entity Type | Organization
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Legal Business Name | WEAVERS BUSINESS SERVICES INC
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 104 E TELEPHONE ST 104 E TELEPHONE ST
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City | SYLVANIA
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State | GA
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Zip | 30467-1959
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Country | US
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Telephone | 912-564-2513
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Fax | 912-564-2750
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Provider Business Mailing Address
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Address Line | 803 W OGEECHEE ST
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City | SYLVANIA
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State | GA
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Zip | 30467-8696
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Country | US
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Telephone | 912-564-1118
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Fax | 912-564-1119
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TERESA B WEAVER
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Credential |
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Telephone | 912-978-1210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | GA
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