Organization
RACHEL HOUSE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORETHA KAY DORMINEY LPN (MANAGER)
(229) 549-6100
Entity
Organization
Contact information
Practice address
204 W COLQUITT ST, SPARKS, GA 31647
(229) 549-6100
(229) 549-6100
Mailing address
PO BOX 117, SPARKS, GA 31647-0117
(229) 549-6100
(229) 549-6100
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
037-02-004-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000893241A
—
GA
Enumeration date
06/29/2007
Last updated
06/19/2008
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