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Organization

HOMECARE PROVIDERS SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHEILA G BUTT (ADMINSTRATOR)
(678) 760-8886
Entity
Organization

Contact information

Practice address
3949 ELMSIDE VILLAGE LN, SUITE F, NORCROSS, GA 30092-7216
(678) 760-8886
Mailing address
PO BOX 895, STONE MOUNTAIN, GA 30086-0895
(678) 760-8886

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
534170545A
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
534170545A
GA
Enumeration date
07/17/2008
Last updated
07/17/2008
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