# HOME BROKERAGE CASE MANAGEMENT

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

## Provider details

- **NPI number:** 1649857988
- **Authorized official:** CHARITY A EZEASORE RN (CASE MANAGER)
- **Authorized official phone:** (770) 906-7421

## Contact information

- **Practice address:** 255 JULIA CT, FAYETTEVILLE, GA 30214-7132
- **Practice address phone:** (770) 906-7421
- **Mailing address:** 255 JULIA CT, FAYETTEVILLE, GA 30214-7132
- **Mailing address phone:** (770) 906-7421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 03/24/2021
- **Last updated:** 03/24/2021