Organization
GEORGIA PREMIUM PERSONAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE JOHNSON (OWNER)
(404) 857-8639
Entity
Organization
Contact information
Practice address
2107 GARDEN WOOD CT, ATLANTA, GA 30349-6290
(404) 863-1541
Mailing address
2107 GARDEN WOOD CT, ATLANTA, GA 30349-6290
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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