Organization
UNDER THE SHADOWS PRIVATE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATRELL JENKINS (OWNER)
(912) 978-8282
Entity
Organization
Contact information
Practice address
208 CURTIS STREET, SYLVANIA, GA 30467
(912) 978-8282
Mailing address
208 CURTIS ST, SYLVANIA, GA 30467-2432
(912) 564-5865
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
047470140
GA
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
Update your record
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