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General NPI Number Information
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NPI Number | 1740805753
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Entity Type | Organization
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Legal Business Name | COMPLETE NURSING CARE, LLC
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 8305 OFFICE PARK DR STE C
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-6935
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Country | US
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Telephone | 404-316-3631
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Fax | 678-402-7521
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Provider Business Mailing Address
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Address Line | 5688 WOODLAND GREENS RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-5885
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Country | US
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Telephone | 404-316-3631
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Fax | 678-402-7521
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Authorized Official
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Title or Position | OWNER
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Name | RONNIE MCKELLER
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Credential | RN
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Telephone | 404-316-3631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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