Organization Name: | IDEAL HOME CARE OF GA |
NPI Number: | 1003934795 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | APRIL HOFFMAN (RNADMINSTRATOR) |
Mailing Address: | 182 Riley Ave Ste F2 Macon |
State: | GA US |
Postal Code: | 312040778 |
Phone Number: | 4787571002 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 055R0004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |