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General NPI Number Information
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NPI Number | 1578067088
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Entity Type | Organization
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Legal Business Name | HERITAGEFIRST HOME CARE OF CENTRAL GEORGIA INC.
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 1930 ROBIN CIR
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-2053
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Country | US
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Telephone | 478-234-0070
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Fax | 800-537-4041
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Provider Business Mailing Address
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Address Line | 1277 TWIN PINE RD
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-4231
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Country | US
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Telephone | 478-234-0070
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Fax |
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MR. JOSHUA BERNARD FLOURNOY
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Credential |
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Telephone | 478-234-0070
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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 | 005R1861
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License Number State | GA
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