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General NPI Number Information
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NPI Number | 1154218014
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Entity Type | Organization
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Legal Business Name | BARKSDALE PERSONAL CARE HOME
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 242 N OLIVER ST
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City | ELBERTON
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State | GA
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Zip | 30635-1444
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Country | US
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Telephone | 706-567-8491
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Fax | 706-567-8491
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Provider Business Mailing Address
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Address Line | 242 N OLIVER ST
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City | ELBERTON
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State | GA
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Zip | 30635-1444
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Country | US
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Telephone | 706-567-8491
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Fax | 706-567-8491
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Authorized Official
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Title or Position | CEO
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Name | CASSANDRA D BARKSDALE
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Credential |
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Telephone | 706-567-8491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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