Organization
HOME BROKERAGE CASE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARITY A EZEASORE RN (CASE MANAGER)
(770) 906-7421
Entity
Organization
Contact information
Practice address
255 JULIA CT, FAYETTEVILLE, GA 30214-7132
(770) 906-7421
Mailing address
255 JULIA CT, FAYETTEVILLE, GA 30214-7132
(770) 906-7421
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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