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General NPI Number Information
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NPI Number | 1245453620
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Entity Type | Organization
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Legal Business Name | PREVENTIVE CARE SERVICES, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 3961 FLOYD RD # 300335
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City | AUSTELL
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State | GA
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Zip | 30106-8535
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Country | US
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Telephone | 770-319-8201
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Fax | 770-234-3890
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Provider Business Mailing Address
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Address Line | 3961 FLOYD RD # 300335
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City | AUSTELL
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State | GA
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Zip | 30106-8535
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Country | US
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Telephone | 770-319-8201
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Fax | 770-234-3890
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | CHERYL REGINA EAVES
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Credential | RN
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Telephone | 770-319-8201
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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 |
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License Number State |
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