# CEDAR GROVE PRIVATE HOME CARE

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

## Provider details

- **NPI number:** 1447835947
- **Authorized official:** MISS LANIECE APPLING (OWNWE)
- **Authorized official phone:** (706) 743-6133

## Contact information

- **Practice address:** 245 S WOODLAWN DR, CRAWFORD, GA 30630-2622
- **Practice address phone:** (706) 743-6133
- **Mailing address:** 245 S WOODLAWN DR, CRAWFORD, GA 30630-2622
- **Mailing address phone:** (706) 743-6133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | — | Yes |
| 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