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NPI Code Detail

MEDICARE: EDUCARE HOME CARE SERVICES LLC

MEDICARE: EDUCARE HOME CARE SERVICES LLC
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1720484397
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDUCARE HOME CARE SERVICES LLC
Provider Business Mailing Address
First Line : 6741 CHURCH ST STE 4
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2249
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6741 CHURCH ST STE 4
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2249
Country : US
Telephone Number : 678-308-3767
Fax Number :
Authorized Official
Title or Position : PERSONAL CARE SUPERVISOR
Name : BRENDANETTE COLLINS I
Credential :
Telephone Number : 678-308-3767
Provider Enumeration Date : 11/10/2014
Last Update Date : 11/24/2014

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Directions to “EDUCARE HOME CARE SERVICES LLC ” Practice Location

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