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General NPI Number Information
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NPI Number | 1851794861
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Entity Type | Organization
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Legal Business Name | STABLE CARE SERVICES, INC
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/03/2014
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Provider Practice Location Address
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Address Line | 1763 TAYLOR OAKS DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-1525
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Country | US
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Telephone | 678-698-8840
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Fax |
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Provider Business Mailing Address
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Address Line | 1763 TAYLOR OAKS DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-1525
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Country | US
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Telephone | 678-698-8840
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SILVERLYNE U CHUKWURAH
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Credential | MPH
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Telephone | 678-698-8840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 067-R-1204
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License Number State | GA
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