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General NPI Number Information
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NPI Number | 1477136158
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Entity Type | Organization
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Legal Business Name | MBC CARE LLC DBA EMERALD HOME CARE
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 1917 KENSINGTON HIGH ST SW
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City | LILBURN
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State | GA
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Zip | 30047-2523
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Country | US
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Telephone | 404-694-1445
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Fax | 770-686-3600
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Provider Business Mailing Address
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Address Line | 1917 KENSINGTON HIGH ST SW
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City | LILBURN
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State | GA
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Zip | 30047-2523
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Country | US
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Telephone | 404-694-1445
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Fax | 770-686-3600
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Authorized Official
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Title or Position | OWNER
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Name | MICHELL ANNE CAPODANNO
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Credential |
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Telephone | 404-694-1445
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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 |
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License Number State |
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