# HOME CARE SERVICES OF NORTHEAST GEORGIA, INC.

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

## Provider details

- **NPI number:** 1457840167
- **Authorized official:** THOMAS KIMMES (PRINCIPAL)
- **Authorized official phone:** (678) 481-4829

## Contact information

- **Practice address:** 6105 STILLWATER TRL, FLOWERY BRANCH, GA 30542-5363
- **Practice address phone:** (404) 550-2916
- **Mailing address:** 7433 SPOUT SPRINGS RD STE 101-56, FLOWERY BRANCH, GA 30542-7766
- **Mailing address phone:** (404) 550-2916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2018
- **Last updated:** 05/08/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 20262268433 | STATE TAX ID | GA |