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General NPI Number Information
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NPI Number | 1194092742
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Entity Type | Organization
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Legal Business Name | RATLIFF PRIVATE HOME CARE
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 187 ROBERSON MILL RD NE SUITE 110
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-4960
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Country | US
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Telephone | 478-295-2626
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Fax | 478-295-2630
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Provider Business Mailing Address
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Address Line | 187 ROBERSON MILL RD NE SUITE 110
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-4960
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Country | US
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Telephone | 478-295-2626
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Fax | 478-295-2630
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ANNETTE T TRAWICK
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Credential | RNNURSE PRACTITIONAL
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Telephone | 478-295-2626
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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 | 005-R-0273
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License Number State | GA
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