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General NPI Number Information
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NPI Number | 1669707196
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Entity Type | Organization
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Legal Business Name | YOUR BEST FRIEND LLC
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Dates
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Enumeration Date | 10/17/2009
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Last Update Date | 10/17/2009
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Provider Practice Location Address
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Address Line | 3690 OAK PARK DR
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City | SUWANEE
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State | GA
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Zip | 30024-1868
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Country | US
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Telephone | 404-456-7952
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Fax |
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Provider Business Mailing Address
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Address Line | 6555 SUGARLOAF PKWY #307-121
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City | DULUTH
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State | GA
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Zip | 30097-4930
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Country | US
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Telephone | 404-456-7952
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | GRETA O DEFFENDALL
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Credential |
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Telephone | 404-456-7952
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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 | 2009000029
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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 | 2009000029
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License Number State | GA
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