Provider Demographics
NPI:1033992409
Name:BACK TO THE BASICS NURSING SERVICES, LLC
Entity Type:Organization
Organization Name:BACK TO THE BASICS NURSING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAMONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:478-796-3858
Mailing Address - Street 1:179 GOODALL WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31216-6498
Mailing Address - Country:US
Mailing Address - Phone:478-796-3858
Mailing Address - Fax:
Practice Address - Street 1:179 GOODALL WOODS DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-6498
Practice Address - Country:US
Practice Address - Phone:478-796-3858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No282E00000XHospitalsLong Term Care Hospital