MEDICARE: CURRAHEE HOME BUILDERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	RBCO004015	GA

General Provider Information

NPI Number	:	1184995243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURRAHEE HOME BUILDERS, INC

Provider Business Mailing Address
First Line	:	2763 MEADOW CHURCH RD
Second Line	:	SUITE 200
City	:	DULUTH
State	:	GA
Zip	:	30097-4989
Country	:	US
Telephone Number	:	678-859-6112
Fax Number	:	770-476-3132

Provider Business Practice Location Address
First Line	:	2763 MEADOW CHURCH RD
Second Line	:	SUITE 200
City	:	DULUTH
State	:	GA
Zip	:	30097-4989
Country	:	US
Telephone Number	:	678-859-6112
Fax Number	:	770-476-3132

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MIKE A. ELROD
Credential	:
Telephone Number	:	678-859-6112

Provider Enumeration Date	:	01/21/2012
Last Update Date	:	01/21/2012

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