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General NPI Number Information
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NPI Number | 1568846798
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Entity Type | Organization
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Legal Business Name | YOUR ELITE COMPANION SITTING AND HEALTHCARE SERVICES
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 3235 SATELLITE BLVD BLDG 400 SUITE 300
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City | DULUTH
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State | GA
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Zip | 30096-8687
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Country | US
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Telephone | 770-875-9234
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Fax | 678-253-0227
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Provider Business Mailing Address
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Address Line | 3163 DOVE CT SUITE A
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City | SNELLVILLE
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State | GA
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Zip | 30078-3652
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Country | US
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Telephone | 770-875-9234
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MISS CORNELIA WILLIAMS
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Credential | RN-CEO
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Telephone | 404-781-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 067-R-1275
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License Number State | GA
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