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Organization
STAY HOME NURSING SERVICES LLC
Active
Organization
STAY HOME NURSING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE EDWARDS NP (OWNER)
(678) 237-7183
Entity
Organization
Contact information
Practice address
11084 TORINO DR, HAMPTON, GA 30228-6446
(678) 815-5446
(770) 872-8267
Mailing address
PO BOX 926, MCDONOUGH, GA 30253-0926
(678) 815-5446
(770) 872-8267
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
251B00000X
Case Management Agency
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
251J00000X
Nursing Care Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
251T00000X
PACE Provider Organization
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
385H00000X
Respite Care
—
NULL
385HR2055X
Child Mental Illness Respite Care
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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