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General NPI Number Information
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NPI Number | 1225324486
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Entity Type | Organization
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Legal Business Name | ASSISTED HEALTH CARE, LLC
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 2952 BRIDGEPORT DR
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City | AUGUSTA
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State | GA
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Zip | 30909-9697
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Country | US
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Telephone | 706-504-3209
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Fax | 706-504-3209
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Provider Business Mailing Address
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Address Line | 2952 BRIDGEPORT DR
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City | AUGUSTA
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State | GA
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Zip | 30909-9697
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Country | US
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Telephone | 706-504-3209
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Fax | 706-504-3209
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Authorized Official
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Title or Position | ADMINISTRATO
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Name | MS. LINDA GAYLE BENTLEY
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Credential | LPN
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Telephone | 706-504-3209
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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 | 121-R-0861
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License Number State | GA
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