MEDICARE: SOMEONE CARES, INC. OF ATLANTA

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	282NC0060X	Critical Access Hospital	GA0117	GA
2	251S00000X	Community/Behavioral Health Agency	GA0117	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11D1094206	OTHER	GA	CLIA
2	133767	OTHER	GA	BUSINESS OCCUPATION COBB COUNTY

General Provider Information

NPI Number	:	1346654605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMEONE CARES, INC. OF ATLANTA

Provider Business Mailing Address
First Line	:	1950 SPECTRUM CIR SE STE 145
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-8470
Country	:	US
Telephone Number	:	678-921-2707
Fax Number	:	345-388-8649

Provider Business Practice Location Address
First Line	:	1950 SPECTRUM CIR SE STE 145
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-8470
Country	:	US
Telephone Number	:	678-921-2707
Fax Number	:	345-388-8649

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	RONNIE E BASS
Credential	:	MS, BBA
Telephone Number	:	678-234-2445

Provider Enumeration Date	:	06/16/2014
Last Update Date	:	06/16/2014

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Directions to “SOMEONE CARES, INC. OF ATLANTA ” Practice Location

Language	Start Address	Practice Location

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