Organization
PHENOMENAL CARE SOLUTIONS
Active
Other names
No
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE LATRE WEBB (OWNER)
(404) 789-4304
Entity
Organization
Contact information
Practice address
2111 COUNTRY WALK WAY SE APT A, CONYERS, GA 30013-6765
(404) 789-4304
Mailing address
2111 COUNTRY WALK WAY SE APT A, CONYERS, GA 30013-6765
(404) 789-4304
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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