MEDICARE: FRIENDLY NEIGHBORS ALS., 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1245386242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY NEIGHBORS ALS., INC

Provider Business Mailing Address
First Line	:	PO BOX 1637
Second Line	:
City	:	JACKSON
State	:	GA
Zip	:	30233-0032
Country	:	US
Telephone Number	:	770-504-9961
Fax Number	:	770-504-9961

Provider Business Practice Location Address
First Line	:	2571 HIGHWAY 36 E
Second Line	:	BUILDING A
City	:	JACKSON
State	:	GA
Zip	:	30233-3317
Country	:	US
Telephone Number	:	770-504-9961
Fax Number	:	770-504-1808

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. SANDRA MITCHELL
Credential	:
Telephone Number	:	770-504-9961

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/22/2020

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