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General NPI Number Information
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NPI Number | 1780330555
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Entity Type | Organization
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Legal Business Name | FITZ PERSONAL CARE LLC
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 230 S BROAD ST SW
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City | ATLANTA
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State | GA
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Zip | 30161-2964
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Country | US
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Telephone | 770-881-0955
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Fax | 404-393-9370
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Provider Business Mailing Address
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Address Line | 230 S BROAD ST SW
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City | ATLANTA
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State | GA
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Zip | 30161-2964
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Country | US
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Telephone | 770-881-0955
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Fax | 404-393-9370
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | TAMIKA FITZGIBBONS
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Credential |
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Telephone | 770-881-0955
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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 |
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License Number State |
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