Organization
LIVING-IN-CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL TOBIN (PRESIDENT)
(915) 487-7336
Entity
Organization
Contact information
Practice address
716 5TH ST, AUGUSTA, GA 30901-2413
(912) 605-6167
Mailing address
4064 ELLINGTON DR, GROVETOWN, GA 30813-8133
(915) 487-7336
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
225100000X
Physical Therapist
—
—
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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