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Organization

FUNDAMENTAL HEALTH GROUP, LLC

Active
Other names
BrightStar of NW Atlanta
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ADAM JACOB FRASER CSA (PRESIDENT)
(404) 856-7610
Entity
Organization

Contact information

Practice address
550 PEACHTREE ST NE, SUITE 1210, ATLANTA, GA 30308-2237
(404) 856-7610
(866) 266-5030
Mailing address
550 PEACHTREE ST NE, SUITE 1210, ATLANTA, GA 30308-2237
(404) 856-7610
(866) 266-5030

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060-R-1213
HOME CARE PROVIDER LICENSE - SKILLED NURSING, PERSONAL CARE, & COMPANION/SITTER
GA
01
563170
JOINT COMMISSION ACCRED
GA
01
SCSA095804
CERTIFIED SENIOR ADVISOR
GA
Enumeration date
08/27/2013
Last updated
05/28/2015
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