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General NPI Number Information
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NPI Number | 1306483581
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Entity Type | Organization
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Legal Business Name | STAY HOME NURSING SERVICES LLC
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 11084 TORINO DR
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City | HAMPTON
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State | GA
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Zip | 30228-6446
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Country | US
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Telephone | 678-815-5446
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Fax | 770-872-8267
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Provider Business Mailing Address
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Address Line | PO BOX 926
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City | MCDONOUGH
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State | GA
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Zip | 30253-0926
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Country | US
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Telephone | 678-815-5446
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Fax | 770-872-8267
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Authorized Official
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Title or Position | OWNER
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Name | MS. JACQUELINE EDWARDS
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Credential | NP
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Telephone | 678-237-7183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #6
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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Taxonomy #7
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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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Taxonomy #8
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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Taxonomy #9
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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Taxonomy #10
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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Taxonomy #11
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #13
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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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