MEDICARE: GEORGIA ADVOCACY CARE

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

General Provider Information

NPI Number	:	1992348668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGIA ADVOCACY CARE

Provider Business Mailing Address
First Line	:	5579 CHAMBLEE DUNWOODY RD STE B
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-4100
Country	:	US
Telephone Number	:	470-451-3341
Fax Number	:

Provider Business Practice Location Address
First Line	:	5579 CHAMBLEE DUNWOODY RD STE B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-4100
Country	:	US
Telephone Number	:	470-451-3341
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED AGENT
Name	:	KRISTINE AIBANGBEE
Credential	:
Telephone Number	:	470-451-3341

Provider Enumeration Date	:	10/24/2019
Last Update Date	:	04/09/2024

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Directions to “GEORGIA ADVOCACY CARE ” Practice Location

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