Organization
HOME CARE GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM MINICK (DIRECTOR)
(770) 384-0494
Entity
Organization
Contact information
Practice address
1280 WINCHESTER PKWY SE STE 210, SMYRNA, GA 30080-6548
(770) 384-0494
(770) 384-0093
Mailing address
1280 WINCHESTER PKWY SE STE 210, SMYRNA, GA 30080-6548
(770) 384-0494
(770) 384-0093
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033R0079
PRIVATE HOME CARE PROVIDER AGENCY
GA
Enumeration date
10/28/2009
Last updated
10/28/2009
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