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General NPI Number Information
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NPI Number | 1457583718
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Entity Type | Organization
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Legal Business Name | SUNCREST HOME HEALTH OF SOUTH GA, INC.
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Dates
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Enumeration Date | 08/19/2009
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 1221 W 4TH ST STE 7
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City | ADEL
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State | GA
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Zip | 31620-2906
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Country | US
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Telephone | 229-896-8177
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Fax | 229-296-7880
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Provider Business Mailing Address
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Address Line | 1221 W 4TH ST STE 7
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City | ADEL
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State | GA
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Zip | 31620-2906
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Country | US
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Telephone | 229-896-8177
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Fax | 229-896-7880
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Authorized Official
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Title or Position | SECRETARY
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Name | AMBER L TUELLER
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Credential |
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Telephone | 208-207-2726
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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 | 037-101
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License Number State | GA
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