Organization
PROVIDENCE HEALTHCARE OF GEORGIA
Active
Other names
PHG Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
NEIYA SPELLER (ADMINISTRATOR)
(631) 678-6889
Entity
Organization
Contact information
Practice address
6509 BENNINGTON BLUFF CT, MABLETON, GA 30126-7269
(404) 408-8703
Mailing address
6509 BENNINGTON BLUFF CT, MABLETON, GA 30126-7269
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
01/24/2020
Last updated
09/26/2025
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