Organization
SAGE PRIVATE CARE LTD CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAVENIA MARIE SCRIVEN JONES (CEO)
(770) 750-5393
Entity
Organization
Contact information
Practice address
1992 WYNHURST XING, STONE MOUNTAIN, GA 30088-4241
(770) 750-5393
Mailing address
5055 MEMORIAL DR STE A347, STONE MOUNTAIN, GA 30083-3108
(770) 750-5393
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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