GEORGIA IN HOME SUPPORT SERVICES (NPI# 1063424752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063424752 |
Entity Type | Organization |
Organization Name | GEORGIA IN HOME SUPPORT SERVICES |
Practice Address |
155 Zelkova Dr Fayetteville GA 30215-2528 |
Practice Telephone | 6788177338 |
Mailing Telephone | 6788177338 |
Enumeration Date | 2006-08-12 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MS. SHANTEL MARIE FORSTALL (ADMINISTRATOR) |
Authorized Official Telephone | 6788177338 |
Authorized Official Credential | MSW |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 251J00000X | Nursing Care | 056-R-0260 | GA | Agencies |
X | 251E00000X | Home Health | 056-R-0260 | GA | Agencies |
Street Address |
155 ZELKOVA DR |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30215-2528 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
1902264492 | Ty-re Lamont Dixon Sr. | Durable Medical Equipment & Medical Supplies | 220 Shoreline Dr., Fayetteville, GA 30215 | 2016-01-29 |
1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
Find all providers in zip 30215 |
Taxonomy Code | 251J00000X |
Grouping | Agencies |
Classification | Nursing Care |
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. |
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861988420 | Sunvera Home Care LLC | Nursing Care | 240 Youngs Cir, Fayetteville, GA 30215-2765 | 2018-07-07 |
1720431141 | Lifestyle Enrichment Home Care Agency | Nursing Care | 2529 Raeford Rd Ste C6, Fayetteville, NC 28305-5098 | 2016-07-20 |
1568706661 | Connections To Care, LLC | Nursing Care | 105 Habersham Dr, Suite C, Fayetteville, GA 30214-7341 | 2012-11-15 |
1578841029 | Olive Garden Healthcare Serv. LLC | Nursing Care | 90 Commerce Dr Ste A, Fayetteville, GA 30214-7519 | 2011-08-02 |
1861787731 | Jeanette Pulsifer | Nursing Care | 134 Clark Rd, Fayetteville, GA 30215-5520 | 2011-06-17 |
1427284769 | Truecare Enterprise Inc | Nursing Care | 6127 Lochview Dr, Fayetteville, NC 28311-2911 | 2009-06-01 |
1710134770 | Bright Heart Healthcare Staffing | Nursing Care | 2504 Rareford Rd, Fayetteville, NC 28305 | 2008-08-21 |
1780880450 | A Brighter Future Healthcare Services | Nursing Care | 4140 Ferncreek Dr Ste 300, Fayetteville, NC 28314-2566 | 2007-06-21 |
1154456325 | Liberty Nursing Services, LLC | Nursing Care | 2175 Village Dr, Fayetteville, NC 28304-2531 | 2007-02-21 |
1437227626 | Heart To Heart Home Care Agency, Inc. | Nursing Care | 2904 Fort Bragg Rd, Fayetteville, NC 28303-4725 | 2006-12-04 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 30215 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.