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General NPI Number Information
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NPI Number | 1619213733
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Entity Type | Organization
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Legal Business Name | GGBD, LLC ADULT CARE SERVICES
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 8317 OFFICE PARK DR SUITE 1C
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-6936
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Country | US
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Telephone | 888-726-1430
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Fax | 404-410-5626
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Provider Business Mailing Address
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Address Line | PO BOX 81461
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City | ATLANTA
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State | GA
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Zip | 30366-1461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CASONYA KING
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Credential |
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Telephone | 888-726-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 048-R-1175
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 048-R-1175
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 048-R-1175
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 048-R-1175
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License Number State | GA
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