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General NPI Number Information
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NPI Number | 1972762599
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Entity Type | Organization
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Legal Business Name | CARESOUTH HHA HOLDINGS OF MIDDLE GEORGIA, LLC
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 3920 ARKWRIGHT RD STE 325
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City | MACON
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State | GA
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Zip | 31210-1731
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Country | US
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Telephone | 478-742-7557
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Fax | 478-742-8491
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Provider Business Mailing Address
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Address Line | 6688 N CENTRAL EXPRESSWAY SUITE 1300
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City | DALLAS
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State | TX
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Zip | 75206-3950
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Country | US
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Telephone | 214-239-6500
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Fax | 214-239-6581
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Authorized Official
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Title or Position | EVP OF HOME HEALTH OPERATIONS
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Name | JULIE DIANE JOLLEY
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Credential |
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Telephone | 214-239-6500
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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 |
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License Number State | GA
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