# GEORGIA PREMIUM PERSONAL CARE

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

## Provider details

- **NPI number:** 1669029518
- **Authorized official:** MRS. JACQUELINE JOHNSON (OWNER)
- **Authorized official phone:** (404) 857-8639

## Contact information

- **Practice address:** 2107 GARDEN WOOD CT, ATLANTA, GA 30349-6290
- **Practice address phone:** (404) 863-1541
- **Mailing address:** 2107 GARDEN WOOD CT, ATLANTA, GA 30349-6290

## Taxonomy

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

## Other

- **Enumeration date:** 08/23/2019
- **Last updated:** 08/23/2019