Organization
HEALTHSOURCE AGENCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUFINA NORAGBON RN (DIRECTOR OF NURSING)
(770) 310-8794
Entity
Organization
Contact information
Practice address
110 EAGLE SPRING DR, SUITE D, STOCKBRIDGE, GA 30281-2568
(770) 310-8794
(678) 961-5719
Mailing address
110 EAGLE SPRING DR, SUITE D, STOCKBRIDGE, GA 30281-6488
(770) 310-8794
(678) 961-5719
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN165113
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
893591747A
—
GA
Enumeration date
05/03/2009
Last updated
01/27/2017
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