Provider Demographics
NPI:1003287616
Name:WORLDCARE INTERNATIONAL CORPORATION
Entity Type:Organization
Organization Name:WORLDCARE INTERNATIONAL CORPORATION
Other - Org Name:KIDS IN WATERLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUMELOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CKTP, IMC, C/NDT
Authorized Official - Phone:478-474-4035
Mailing Address - Street 1:310 ASHVILLE CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1669
Mailing Address - Country:US
Mailing Address - Phone:478-474-4035
Mailing Address - Fax:478-474-7713
Practice Address - Street 1:4500 BILLY WILLIAMSON DR
Practice Address - Street 2:SUITE 9
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206-8743
Practice Address - Country:US
Practice Address - Phone:478-538-3708
Practice Address - Fax:478-474-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000760702BMedicaid
GA000760702FMedicaid