# STAY HOME NURSING SERVICES LLC

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

## Provider details

- **NPI number:** 1306483581
- **Authorized official:** MS. JACQUELINE EDWARDS NP (OWNER)
- **Authorized official phone:** (678) 237-7183

## Contact information

- **Practice address:** 11084 TORINO DR, HAMPTON, GA 30228-6446
- **Practice address phone:** (678) 815-5446
- **Practice address fax:** (770) 872-8267
- **Mailing address:** PO BOX 926, MCDONOUGH, GA 30253-0926
- **Mailing address phone:** (678) 815-5446
- **Mailing address fax:** (770) 872-8267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 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