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General NPI Number Information
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NPI Number | 1114374451
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Entity Type | Organization
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Legal Business Name | NORTH GEORGIA SENIOR CARE, LLC
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 702 PAT HARALSON DR
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3007
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Country | US
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Telephone | 706-835-3800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2267
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City | BLAIRSVILLE
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State | GA
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Zip | 30514-2267
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Country | US
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Telephone | 706-994-3773
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW WILLIAMS
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Credential |
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Telephone | 706-835-3800
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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 | 144R0829
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License Number State | GA
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