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Organization

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HELEN PETGRAVE (CEO)
(678) 294-2403
Entity
Organization

Contact information

Practice address
5889 WHEELER RIDGE RD, AUBURN, GA 30011-3488
(678) 294-2403
Mailing address
5889 WHEELER RIDGE RD, AUBURN, GA 30011-3488

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
251J00000X
Nursing Care Agency
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
11/29/2024
Last updated
11/29/2024
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