Organization
CONCOH HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NNEKA PAT ETO (ADMINISTRATOR)
(770) 875-2759
Entity
Organization
Contact information
Practice address
5883 HERITAGE LN, STONE MOUNTAIN, GA 30087-1848
(770) 875-2759
Mailing address
5883 HERITAGE LN, STONE MOUNTAIN, GA 30087-1848
(770) 875-2759
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
044-R-0676
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003131517A
—
GA
Enumeration date
05/23/2014
Last updated
05/23/2014
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