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General NPI Number Information
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NPI Number | 1629468392
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Entity Type | Organization
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Legal Business Name | A SUPERIOR CHOICE MEDICAL STAFFING LLC
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 5881 GLENRIDGE DR SUITE 140
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City | ATLANTA
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State | GA
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Zip | 30328-5301
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Country | US
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Telephone | 404-257-1608
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Fax | 404-257-1609
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Provider Business Mailing Address
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Address Line | 5881 GLENRIDGE DR SUITE 140
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City | ATLANTA
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State | GA
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Zip | 30328-5301
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Country | US
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Telephone | 404-257-1608
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Fax | 404-257-1609
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Authorized Official
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Title or Position | CEO
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Name | MR. BRIAN LACEY
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Credential |
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Telephone | 678-464-1397
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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 | 060-R-0154
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 060-R-0154
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License Number State | GA
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