| Organization Name: | HOME HEALTH AGENCY OF GEORGIA, LLC |
| NPI Number: | 1194035766 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILFORD A. PAYNE (PRESIDENT / CEO) |
| Mailing Address: | 1705 Enterprise Way Se Suite 102 Marietta |
| State: | GA US |
| Postal Code: | 300679224 |
| Phone Number: | 6782185745 |
| Fax Number: | 7707948302 |
| NPI Enumeration Date: | 10/18/2010 |
| NPI Last Update Date: | 08/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 033 034 10 H |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |