# CUSTOM CARING, LLC

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

## Provider details

- **NPI number:** 1548512726
- **Authorized official:** MR. JAMES D WIDEMAN (MANAGING MEMBER)
- **Authorized official phone:** (678) 396-0578

## Contact information

- **Practice address:** 2304 PAR THREE WAY, LITHONIA, GA 30038-1801
- **Practice address phone:** (678) 396-0578
- **Mailing address:** 2304 PAR THREE WAY, LITHONIA, GA 30038-1801
- **Mailing address phone:** (678) 396-0578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | GA | Yes |

## Other

- **Enumeration date:** 10/11/2012
- **Last updated:** 10/11/2012