Organization
SOUTHERN CRESCENT CARE,LLC
Active
Other names
Home Helpers
Organization subpart
No
Provider details
NPI number
Authorized official
MARY POORE LCSW, CNA (OWNER)
(678) 565-8700
Entity
Organization
Contact information
Practice address
135 EAGLES WALK, SUITE 325 A, STOCKBRIDGE, GA 30281-7206
(678) 565-8700
(678) 565-8775
Mailing address
135 EAGLES WALK, SUITE 325 A, STOCKBRIDGE, GA 30281-7206
(678) 565-8700
(678) 565-8775
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
075-R-0012
GA
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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