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General NPI Number Information
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NPI Number | 1710017702
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Entity Type | Organization
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Legal Business Name | INTOUCH HOME CARE SERVICES
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 1655 CHASE RIDGE LN 1655
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-4369
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Country | US
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Telephone | 678-377-5515
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Fax | 770-236-3326
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Provider Business Mailing Address
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Address Line | CHASE RIDGE LN 1655
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043
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Country | US
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Telephone | 678-377-5515
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Fax | 770-236-3326
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KINGSLEY IGBINOSUN
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Credential |
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Telephone | 678-377-5515
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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 | 067-R-0228
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License Number State | GA
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