MEDICARE: CARE SERVICES AT HOME

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	251J00000X	Nursing Care Agency	033-R-0109	GA

General Provider Information

NPI Number	:	1699169789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE SERVICES AT HOME

Provider Business Mailing Address
First Line	:	165 W WIEUCA RD NE
Second Line	:	SUITE 303
City	:	ATLANTA
State	:	GA
Zip	:	30342-3252
Country	:	US
Telephone Number	:	404-246-4935
Fax Number	:	404-748-9695

Provider Business Practice Location Address
First Line	:	165 W WIEUCA RD NE
Second Line	:	SUITE 303
City	:	ATLANTA
State	:	GA
Zip	:	30342
Country	:	US
Telephone Number	:	404-246-4935
Fax Number	:	404-748-9695

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. LOUIS MAHACHI
Credential	:
Telephone Number	:	404-246-4935

Provider Enumeration Date	:	03/26/2015
Last Update Date	:	03/26/2015

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Directions to “CARE SERVICES AT HOME ” Practice Location

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