# PEACHTREE HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205482098
- **Authorized official:** MR. DOMINIC ANTHONY WILLIAMS RN (OWNER)
- **Authorized official phone:** (870) 945-5038

## Contact information

- **Practice address:** 1220 MECASLIN ST NW APT 2432, ATLANTA, GA 30318-5659
- **Practice address phone:** (870) 945-5038
- **Mailing address:** 1220 MECASLIN ST NW APT 2432, ATLANTA, GA 30318-5659
- **Mailing address phone:** (870) 945-5038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/16/2019
- **Last updated:** 08/16/2019