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General NPI Number Information
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NPI Number | 1245791185
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Entity Type | Organization
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Legal Business Name | HUTCHINSON CARE NETWORK INC
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 05/29/2022
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Provider Practice Location Address
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Address Line | 1775 PARKER RD SE STE 210
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City | CONYERS
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State | GA
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Zip | 30094-6654
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Country | US
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Telephone | 678-315-3656
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 83057
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City | CONYERS
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State | GA
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Zip | 30013-8014
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Country | US
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Telephone | 678-315-3656
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATOR
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Name | DOROTHEA DENNIS
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Credential | CNA
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Telephone | 678-315-3656
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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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