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General NPI Number Information
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NPI Number | 1356707202
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Entity Type | Organization
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Legal Business Name | AFFLUENT HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-252-2169
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Fax | 678-252-2170
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Provider Business Mailing Address
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Address Line | 2330 SCENIC HWY S
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-252-2169
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Fax | 678-252-2170
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Authorized Official
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Title or Position | OWNER
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Name | KAALA CHERIE JOHNSON
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Credential | CNA, BLS INST
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Telephone | 678-252-2169
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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 | 067-R-1514
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License Number State | GA
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