# VILLAGE SAMARITAN, LLC

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

## Provider details

- **NPI number:** 1760621676
- **Authorized official:** PASCHA N WILLIAMS LPN (EXECUTIVE DIRECTOR / OWNER)
- **Authorized official phone:** (770) 830-5683

## Contact information

- **Practice address:** 907 S PARK ST STE H, CARROLLTON, GA 30117-4455
- **Practice address phone:** (770) 830-5683
- **Practice address fax:** (770) 200-1959
- **Mailing address:** 907 S PARK ST STE H, CARROLLTON, GA 30117-4455
- **Mailing address phone:** (770) 830-5683
- **Mailing address fax:** (770) 200-1959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 022-R-0494 | GA | Yes |

## Other

- **Enumeration date:** 02/17/2009
- **Last updated:** 02/17/2009