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General NPI Number Information
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NPI Number | 1710472857
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Entity Type | Organization
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Legal Business Name | CATERING TO CARE PERSONAL CARE HOME
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 405 BARNHILL DR
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City | SAVANNAH
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State | GA
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Zip | 31406-5912
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Country | US
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Telephone | 912-257-9346
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Fax |
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Provider Business Mailing Address
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Address Line | 405 BARNHILL DR
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City | SAVANNAH
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State | GA
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Zip | 31406-5912
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Country | US
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Telephone | 912-257-9346
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANITA POND
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Credential |
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Telephone | 912-257-9346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | PCH009279
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License Number State | GA
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