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General NPI Number Information
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NPI Number | 1942515085
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Entity Type | Organization
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Legal Business Name | TOTAL CARE GROUP HOMES, LLC
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 08/13/2010
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Provider Practice Location Address
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Address Line | 5570 PLATTE DR
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City | ELLENWOOD
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State | GA
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Zip | 30294-6656
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Country | US
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Telephone | 770-961-4312
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Fax | 770-216-1656
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Provider Business Mailing Address
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Address Line | PO BOX 228
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City | EASLEY
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State | SC
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Zip | 29641-0228
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Country | US
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Telephone | 770-961-4312
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Fax | 770-216-1658
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Authorized Official
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Title or Position | OWNER
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Name | BRADLY J ELROD
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Credential |
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Telephone | 864-238-5657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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