Organization
PERSONAL SENIOR HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA K JORDAN (OWNER/RN)
(404) 606-8430
Entity
Organization
Contact information
Practice address
981 LUTHER ST SE, ATLANTA, GA 30315-6923
(404) 606-8430
Mailing address
600 HIGHPOINT WAY, MCDONOUGH, GA 30253-4699
(404) 606-8430
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255703088
—
GA
Enumeration date
11/14/2022
Last updated
11/14/2022
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