# INTERIM HEALTHCARE OF NORTHEAST GEORGIA INC

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

## Provider details

- **NPI number:** 1407986391
- **Authorized official:** MS. LACY ANN KENNY R.N. (VICE PRESIDENT)
- **Authorized official phone:** (770) 534-0083

## Contact information

- **Practice address:** 1062 THOMPSON BRIDGE RD, SUITE B-7, GAINESVILLE, GA 30501-1762
- **Practice address phone:** (770) 534-0083
- **Practice address fax:** (770) 534-2443
- **Mailing address:** 1062 THOMPSON BRIDGE RD, SUITE B-7, GAINESVILLE, GA 30501-1762
- **Mailing address phone:** (770) 534-0083
- **Mailing address fax:** (770) 534-2443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 069-R-0021 | GA | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 08/22/2020