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General NPI Number Information
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NPI Number | 1740692201
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Entity Type | Organization
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Legal Business Name | ELDER HOME CARE,INC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 2759 DELK RD SE SUIT#2135
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City | MARIETTA
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State | GA
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Zip | 30067-8847
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Country | US
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Telephone | 770-937-9003
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Fax | 770-937-9004
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Provider Business Mailing Address
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Address Line | 2759 DELK RD SE SUIT#2135
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City | MARIETTA
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State | GA
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Zip | 30067-8847
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Country | US
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Telephone | 770-937-9003
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Fax | 770-937-9004
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Authorized Official
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Title or Position | VICE PRICEDENT
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Name | MR. JIGISH PATEL
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Credential |
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Telephone | 770-937-9003
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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 | 033R0324
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License Number State | GA
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