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General NPI Number Information
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NPI Number | 1871931279
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Entity Type | Organization
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Legal Business Name | ADULT HOMES SERVICES
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 655 FRONTAGE RD E
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City | SYLVANIA
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State | GA
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Zip | 30467-4800
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Country | US
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Telephone | 912-564-1148
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Fax | 912-564-0015
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Provider Business Mailing Address
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Address Line | 803 BEST BRIDGE RD
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City | SYLVANIA
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State | GA
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Zip | 30467-8216
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Country | US
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Telephone | 912-564-1148
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Fax | 912-564-0015
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD EVANS
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Credential |
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Telephone | 912-536-5546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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