=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568840320
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAY SO PRIVATE HOME CARE SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2015
-----------------------------------------------------
Last Update Date | 05/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4485 DORSET CIR
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30035-4206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-896-6469
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4485 DORSET CIR
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30035-4206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-896-6469
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MS. SONIA RAMSAY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 770-896-6469
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number | CN0030024790
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------