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General NPI Number Information
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NPI Number | 1972477206
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Entity Type | Organization
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Legal Business Name | WYNNCO CARE LLC
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 5930 HIGHWAY 85 STE 502
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City | RIVERDALE
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State | GA
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Zip | 30274-1502
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Country | US
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Telephone | 404-551-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 3303 TULIP DR
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City | DECATUR
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State | GA
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Zip | 30032-3850
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Country | US
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Telephone | 404-551-7773
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID WYNN
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Credential |
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Telephone | 404-551-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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