Organization
ATLANTIC HOMEAID INC
Active
Other names
SunCrest Companion Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA L PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1710 BOULEVARD SQ STE B, WAYCROSS, GA 31501-8026
(912) 285-9924
(912) 285-0987
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 443-4154
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
148R0001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00699971A
CCSP
GA
05
—
00699971C
—
GA
Enumeration date
11/09/2005
Last updated
03/15/2024
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