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General NPI Number Information
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NPI Number | 1407212012
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Entity Type | Organization
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Legal Business Name | SHIRLEY & NAOMI PRIVATE HOME CARE SERVICES & TRANSPORTATION
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 3723 ARMINTO DR
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City | ELLENWOOD
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State | GA
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Zip | 30294-6663
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Country | US
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Telephone | 404-226-8541
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Fax | 770-389-8554
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Provider Business Mailing Address
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Address Line | 3723 ARMINTO DR
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City | ELLENWOOD
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State | GA
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Zip | 30294-6663
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Country | US
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Telephone | 404-226-8541
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Fax | 770-389-8554
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JOAN CHERRYL PARRIS-LEUNG
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Credential | LPN
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Telephone | 404-226-8541
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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 | 031-R-1524
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License Number State | GA
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