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General NPI Number Information
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NPI Number | 1336702208
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Entity Type | Organization
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Legal Business Name | HOME HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 629 RONALD REAGAN DR STE 3C
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City | EVANS
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State | GA
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Zip | 30809-7608
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Country | US
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Telephone | 706-854-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 933 BROAD ST STE 301
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City | AUGUSTA
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State | GA
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Zip | 30901-7222
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Country | US
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Telephone | 706-854-7428
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | JOHN M SOUTHERN
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Credential |
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Telephone | 67-854-7428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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License Number State |
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