| Organization Name: | HOME CONVALESCENT CARE |
| NPI Number: | 1033456892 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARJORIE DIANE SMITH (OWNER/MANAGER) |
| Mailing Address: | 140 Bud Harrell Rd 140 Bud Harrelle Rd, Bainbridge |
| State: | GA US |
| Postal Code: | 398177920 |
| Phone Number: | 2292544967 |
| Fax Number: | 2294164267 |
| NPI Enumeration Date: | 01/13/2013 |
| NPI Last Update Date: | 01/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385HR2065X |
| License Number: | 110296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | Respite Care, Physical Disabilities, Child |
| Taxonomy Definition: | A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers. |