Organization
CHANGE OF LIFE COMPANION HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATASHA D YVETTE DUNN (ADMINISTRATOR DIRECTOR (OWNER))
(404) 307-7223
Entity
Organization
Contact information
Practice address
401 TOPAZ TRAIL, PEACHTREE CITY, FAYETTEVILLE, GA 30269
(404) 307-7223
Mailing address
P.O. BOX 87242, COLLEGE PARK, GA 30337
(404) 307-7223
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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