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Organization

IN HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IVAN EVANS (ADMINISTRATOR)
(706) 566-9225
Entity
Organization

Contact information

Practice address
597 SHADY GROVE RD, HURTSBORO, AL 36860-2815
(334) 667-6394
Mailing address
PO BOX 591, HURTSBORO, AL 36860-0591
(334) 667-6394

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
374U00000X
Home Health Aide

Other

Enumeration date
08/08/2021
Last updated
12/19/2024
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