Organization
NORTH GEORGIA PERSONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSE MARY DAVIDSON (OWNER)
(706) 253-0131
Entity
Organization
Contact information
Practice address
501 NORTH MAIN ST., SUITE B, JASPER, GA 30143
(706) 253-0131
(706) 253-0131
Mailing address
501 NORTH MAIN ST., SUITE B, JASPER, GA 30143
(706) 253-0131
(706) 253-0131
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
112-R-0521
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112151A
—
GA
01
—
003112151B
SOURSE
GA
Enumeration date
06/06/2016
Last updated
06/06/2016
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