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General NPI Number Information
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NPI Number | 1578181574
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Entity Type | Organization
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Legal Business Name | EAC HOME SOLUTIONS LLC
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 6319 WILLOWBROOK DR
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City | RIVERDALE
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State | GA
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Zip | 30296-2941
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Country | US
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Telephone | 404-971-3664
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Fax |
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Provider Business Mailing Address
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Address Line | 222 HUMMINGBIRD CT
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City | HAMPTON
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State | GA
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Zip | 30228-6026
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Country | US
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Telephone | 678-414-1101
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARLENE TUCKER
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Credential | RN
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Telephone | 678-414-1101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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