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General NPI Number Information
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NPI Number | 1124335542
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Entity Type | Organization
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Legal Business Name | APP & M PERSONAL CARE HOME
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 118 OLA B LN
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City | MIDWAY
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State | GA
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Zip | 31320-4501
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Country | US
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Telephone | 912-884-5082
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Fax | 912-884-5082
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Provider Business Mailing Address
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Address Line | 118 OLA B LN
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City | MIDWAY
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State | GA
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Zip | 31320-4501
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Country | US
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Telephone | 912-884-5082
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Fax | 912-884-5082
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALICE QUARTERMAN
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Credential |
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Telephone | 912-884-5082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 089-01-036-1
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License Number State | GA
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