# BACCHUS PRIVATE HOME CARE LLC

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

## Provider details

- **NPI number:** 1255820007
- **Authorized official:** COLLEEN ANN BACCHUS-LYNCH (OWNER)
- **Authorized official phone:** (404) 468-7130

## Contact information

- **Practice address:** 4925 BRIDLE POINT PARKWAY, SNELLVILLE, GA 30039
- **Practice address phone:** (404) 468-7130
- **Practice address fax:** (770) 679-0617
- **Mailing address:** 4925 BRIDLE POINT PKWY, SNELLVILLE, GA 30039-3343
- **Mailing address phone:** (404) 468-7130
- **Mailing address fax:** (770) 679-0617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 067-R-1438 | GA | Yes |

## Other

- **Enumeration date:** 05/08/2018
- **Last updated:** 05/08/2018