| Organization Name: | GEORGIA COMMUNITY PRIVATE HOME CARE SERVICES |
| NPI Number: | 1093027641 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IYABO OLATUNDE AKINTOMIDE (OWNER) |
| Mailing Address: | 5644 Hunters Crossing Ct Lithonia |
| State: | GA US |
| Postal Code: | 300381529 |
| Phone Number: | 7709877053 |
| Fax Number: | 7709875571 |
| NPI Enumeration Date: | 07/12/2010 |
| NPI Last Update Date: | 07/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 044-R-0497 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |