Organization
ALLY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDIL JAMA (ADMINISTRATOR)
(404) 910-6174
Entity
Organization
Contact information
Practice address
422 N INDIAN CREEK DR STE D, CLARKSTON, GA 30021-2382
(404) 910-6174
(404) 745-8884
Mailing address
422 N INDIAN CREEK DR STE D, CLARKSTON, GA 30021-2382
(404) 910-6174
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0032041897
—
GA
Enumeration date
09/07/2021
Last updated
09/07/2021
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