=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457472698
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUST FOR YOU PERSONAL SUPPORT SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2007
-----------------------------------------------------
Last Update Date | 06/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3459 HOLCOMB BRIDGE RD STE 100
-----------------------------------------------------
City | PEACHTREE CORNERS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30092-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-853-4595
-----------------------------------------------------
Fax | 770-992-6769
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 117716
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30368-7716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-210-1917
-----------------------------------------------------
Fax | 770-991-9491
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COMPLIANCE OFFICER
-----------------------------------------------------
Name | MARCELLA LYNCH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 470-392-9382
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 056-R-0001
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------