Organization
CENTRAL GEORGIA HEALTH VENTURES, INC
Active
Other names
Life Boutique, D/B/A Central Georgia Home Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRIS WILDE (EVP ENTERPRISE CFO)
(478) 633-1452
Entity
Organization
Contact information
Practice address
800 1ST ST STE 100, MACON, GA 31201-8395
(478) 633-5700
Mailing address
3780 EISENHOWER PKWY, SUITE 5, MACON, GA 31206-0800
(478) 633-5700
(478) 781-3355
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000826042A
—
GA
Enumeration date
01/05/2012
Last updated
08/09/2019
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