Organization
PRUITTHEALTH HOME FIRST, INC.
Active
Other names
Pruitthealth Home First - Blue Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL L PRUITT JR. (CHAIRMAN AND CEO)
(770) 279-6200
Entity
Organization
Contact information
Practice address
6050 APPALACHIAN HIGHWAY, SUITE 4, BLUE RIDGE, GA 30513
(706) 632-9263
(706) 632-0028
Mailing address
1626 JEURGENS COURT, NORCROSS, GA 30093-2219
(770) 279-6200
(706) 827-2048
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300036015B
MEDICAID PAVEE #
GA
05
—
8550800G
—
GA
Enumeration date
03/12/2007
Last updated
01/19/2018
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