Organization
A&C PRIVATE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA C AGWUNOB (ADMINISTRATOR)
(770) 776-6637
Entity
Organization
Contact information
Practice address
4855 IVY RIDGE DR SE, UNIT 405, ATLANTA, GA 30339-1367
(770) 776-6637
Mailing address
4855 IVY RIDGE DR SE, UNIT 405, ATLANTA, GA 30339-1367
(770) 776-6637
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
033-R-1499
GA
Other
Enumeration date
09/24/2016
Last updated
09/24/2016
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