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General NPI Number Information
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NPI Number | 1518592468
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Entity Type | Organization
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Legal Business Name | PEACH STATE CARING HANDS LLC
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Dates
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Enumeration Date | 03/10/2020
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Last Update Date | 03/10/2020
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Provider Practice Location Address
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Address Line | 157 AYLESBURY BLVD
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City | MCDONOUGH
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State | GA
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Zip | 30252-3158
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Country | US
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Telephone | 678-772-8216
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1362
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City | MCDONOUGH
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State | GA
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Zip | 30253-1362
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Country | US
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Telephone | 404-548-3087
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Fax |
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Authorized Official
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Title or Position | DON
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Name | LASHIKA FLOYD
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Credential |
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Telephone | 404-548-3087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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