Organization
SOUTHEAST HOME CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER R SPENCE R.N. (OWNER)
(478) 297-4755
Entity
Organization
Contact information
Practice address
312 N DAVIS DR, WARNER ROBINS, GA 31093-3350
(478) 951-7769
(855) 898-0022
Mailing address
312 N DAVIS DR, WARNER ROBINS, GA 31093-3350
(478) 951-7769
(855) 898-0022
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
076-R-119
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076-R-1119
PRIVATE HOME CARE PROVIDER LICENSE/HFR/DCH
GA
Enumeration date
01/30/2017
Last updated
01/30/2017
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