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General NPI Number Information
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NPI Number | 1679155824
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Entity Type | Organization
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Legal Business Name | COMPANION CARE OF GEORGIA, LLC
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 46875 GA HIGHWAY 46 E
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City | METTER
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State | GA
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Zip | 30439-4936
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Country | US
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Telephone | 912-685-4540
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Fax | 912-685-4540
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Provider Business Mailing Address
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Address Line | 46875 GA HIGHWAY 46 E
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City | METTER
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State | GA
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Zip | 30439-4936
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Country | US
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Telephone | 912-685-4540
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Fax | 912-685-4540
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. STEPHEN CHARLES TAYLOR JR.
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Credential |
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Telephone | 912-685-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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