MEDICARE: -

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	372600000X	Adult Companion
3	374U00000X	Home Health Aide
4	376J00000X	Homemaker
5	385H00000X	Respite Care
6	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1962294751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	-

Provider Business Mailing Address
First Line	:	42 W TEDDY BEAR LN
Second Line	:
City	:	WAVERLY HALL
State	:	GA
Zip	:	31831-2446
Country	:	US
Telephone Number	:	678-886-3478
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 DEVONSHIRE DR STE 1600
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6000
Country	:	US
Telephone Number	:	470-826-3466
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	DR. DEBORAH ANN SYKES-TUCKER
Credential	:	DBA
Telephone Number	:	706-573-9530

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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