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Organization
GEORGIA IN HOME SUPPORT SERVICES
Active
Organization
GEORGIA IN HOME SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANTEL MARIE FORSTALL MSW (ADMINISTRATOR)
(678) 817-7338
Entity
Organization
Contact information
Practice address
155 ZELKOVA DR, FAYETTEVILLE, GA 30215-2528
(678) 817-7338
Mailing address
155 ZELKOVA DR, FAYETTEVILLE, GA 30215-2528
(678) 817-7338
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
056-R-0260
GA
251J00000X
Nursing Care Agency
056-R-0260
GA
Other
Enumeration date
08/12/2006
Last updated
09/11/2025
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