# EXPRESS HOME CARE GEORGIA

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

## Provider details

- **NPI number:** 1881955607
- **Authorized official:** VIVIAN MCCULLOM (ADMINISTRATOR)
- **Authorized official phone:** (770) 948-8112

## Contact information

- **Practice address:** 231 MAXHAM RD, SUITE 100, AUSTELL, GA 30168-5523
- **Practice address phone:** (770) 948-8112
- **Practice address fax:** (770) 948-8113
- **Mailing address:** 231 MAXHAM RD, SUITE 100, AUSTELL, GA 30168-5523
- **Mailing address phone:** (770) 948-8112
- **Mailing address fax:** (770) 948-8113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 048R1033 | FM | Yes |

## Other

- **Enumeration date:** 06/07/2012
- **Last updated:** 06/07/2012