Organization Name: | ANDERSON'S CCBI |
NPI Number: | 1164729646 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA E ANDERSON (CEO) |
Mailing Address: | 1581 Queen Elizabeth Dr Locust Grove |
State: | GA US |
Postal Code: | 302483660 |
Phone Number: | 6782650809 |
Fax Number: | |
NPI Enumeration Date: | 02/18/2011 |
NPI Last Update Date: | 02/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | RBI002004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |