Provider Demographics
NPI:1033979380
Name:DAVIS, SHELAINE V (CEO TRACKSS HOME CAR)
Entity Type:Individual
Prefix:
First Name:SHELAINE
Middle Name:V
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CEO TRACKSS HOME CAR
Other - Prefix:MS
Other - First Name:SHELAINE
Other - Middle Name:
Other - Last Name:DAVIS TRACKSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGENT
Mailing Address - Street 1:1635 EAST PARK VALDOSTA. GA A9
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602
Mailing Address - Country:US
Mailing Address - Phone:585-448-7117
Mailing Address - Fax:
Practice Address - Street 1:1635 EAST PARK VALDOSTA. GA A9
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602
Practice Address - Country:US
Practice Address - Phone:585-448-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor