Organization
GENTLEMAN HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PHILLIPS MD (CEO)
(914) 943-1442
Entity
Organization
Contact information
Practice address
4586 VALLEY PKWY SE UNITE E, 4586 VALLEY PKWY SE UNIT E, SMYRNA, GA 30082
(914) 943-1442
Mailing address
4586 VALLEY PKWY SE UNITE E, 4586 VALLEY PKWY SE UNIT E, SMYRNA, GA 30082
(914) 943-1442
Taxonomy
Speciality
Code
Description
License number
State
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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