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Organization
CEDAR GROVE PRIVATE HOME CARE
Active
Organization
CEDAR GROVE PRIVATE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LANIECE APPLING (OWNWE)
(706) 743-6133
Entity
Organization
Contact information
Practice address
245 S WOODLAWN DR, CRAWFORD, GA 30630-2622
(706) 743-6133
Mailing address
245 S WOODLAWN DR, CRAWFORD, GA 30630-2622
(706) 743-6133
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
302F00000X
Exclusive Provider Organization
—
—
305S00000X
Point of Service
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
03/16/2021
Last updated
03/31/2021
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