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General NPI Number Information
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NPI Number | 1831346600
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Entity Type | Organization
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Legal Business Name | SENIOR HOMECARE BY A CIRCLE OF FRIENDS
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 1401 PEACHTREE ST SUITE 500-85
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City | ATLANTA
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State | GA
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Zip | 30309-3023
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Country | US
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Telephone | 404-872-3733
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Fax | 404-962-6928
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Provider Business Mailing Address
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Address Line | 1401 PEACHTREE ST SUITE 500-85
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City | ATLANTA
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State | GA
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Zip | 30309-3023
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Country | US
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Telephone | 404-872-3733
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Fax | 404-962-6928
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. PATRICIA WILLIAMS GOODGAME
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Credential |
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Telephone | 404-451-0600
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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 | 060-R-0454
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License Number State | GA
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