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General NPI Number Information
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NPI Number | 1780046268
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Entity Type | Individual
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Provider Name | VALERIE RACHEL
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Gender | Female
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 8486 PARK RIDGE LN
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City | RIVERDALE
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State | GA
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Zip | 30274-4347
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Country | US
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Telephone | 678-886-7320
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11
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City | ATLANTA
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State | GA
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Zip | 30301-0011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 031-R-1502
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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