Organization
IHC III
Active
Other names
Independent Life at Home
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN B BOLCH (PRESIDENT-CEO)
(912) 629-2727
Entity
Organization
Contact information
Practice address
3 W PERRY ST, SAVANNAH, GA 31401-3951
(912) 629-2727
Mailing address
3 W PERRY ST, SAVANNAH, GA 31401-3951
(912) 629-2727
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
025R0020
GA
Other
Enumeration date
10/05/2006
Last updated
06/19/2008
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