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Organization
FUNDAMENTAL HEALTH GROUP, LLC
Active
Organization
FUNDAMENTAL HEALTH GROUP, LLC
Active
Other names
BrightStar of NW Atlanta
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM JACOB FRASER CSA (PRESIDENT)
(404) 856-7610
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1210, ATLANTA, GA 30308-2237
(404) 856-7610
(866) 266-5030
Mailing address
550 PEACHTREE ST NE, SUITE 1210, ATLANTA, GA 30308-2237
(404) 856-7610
(866) 266-5030
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060-R-1213
HOME CARE PROVIDER LICENSE - SKILLED NURSING, PERSONAL CARE, & COMPANION/SITTER
GA
01
—
563170
JOINT COMMISSION ACCRED
GA
01
—
SCSA095804
CERTIFIED SENIOR ADVISOR
GA
Enumeration date
08/27/2013
Last updated
05/28/2015
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