# MOMENTS HOME CARE OF GEORGIA, LLC

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

## Provider details

- **NPI number:** 1689448458
- **Authorized official:** STEFANO SMITH (MEMBER)
- **Authorized official phone:** (404) 983-6016

## Contact information

- **Practice address:** 430 IVEY EDWARDS LN, MCDONOUGH, GA 30253-5407
- **Practice address phone:** (631) 452-7327
- **Mailing address:** 430 IVEY EDWARDS LN, MCDONOUGH, GA 30253-5407
- **Mailing address phone:** (631) 452-7327

## Taxonomy

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

## Other

- **Enumeration date:** 11/13/2023
- **Last updated:** 11/13/2023