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General NPI Number Information
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NPI Number | 1710293600
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Entity Type | Organization
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Legal Business Name | DDF CARE
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 08/30/2010
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Provider Practice Location Address
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Address Line | 27 COHRAN LAKE CT
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-7213
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Country | US
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Telephone | 404-542-8898
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Fax |
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Provider Business Mailing Address
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Address Line | 27 COHRAN LAKE CT
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-7213
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Country | US
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Telephone | 404-542-8898
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. BOMYEH NJIKA
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Credential |
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Telephone | 404-542-8898
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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 | 110-R-0776
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License Number State | GA
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