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General NPI Number Information
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NPI Number | 1629334826
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Entity Type | Organization
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Legal Business Name | SPARKS ENTERPRISES AND HOME CARE SERVICES, LLC.
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 04/02/2012
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Provider Practice Location Address
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Address Line | 3666 GARRISON DR SW
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City | ATLANTA
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State | GA
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Zip | 30331-2214
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Country | US
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Telephone | 404-380-4636
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Fax |
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Provider Business Mailing Address
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Address Line | 3666 GARRISON DR SW
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City | ATLANTA
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State | GA
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Zip | 30331-2214
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Country | US
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Telephone | 404-380-4636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LOIS E WEBB
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Credential |
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Telephone | 404-380-4636
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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 | 152983LGB
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License Number State | GA
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