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General NPI Number Information
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NPI Number | 1316228547
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH HOLDINGS OF CSRA, LLC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 3531 WALTON WAY EXT SUITE C
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City | AUGUSTA
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State | GA
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Zip | 30909-1821
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Country | US
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Telephone | 706-922-1283
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Fax | 706-364-3285
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Provider Business Mailing Address
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Address Line | 3531 WALTON WAY EXT SUITE C
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City | AUGUSTA
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State | GA
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Zip | 30909-1821
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Country | US
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Telephone | 706-922-1283
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Fax | 706-364-3285
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Authorized Official
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Title or Position | CEO
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Name | MR. PHILLIP R. MCELHANEY
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Credential |
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Telephone | 706-922-1283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | GA
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