Provider Demographics
NPI:1073192142
Name:PROFESSIONAL CARE COMPANIONS LLC
Entity Type:Organization
Organization Name:PROFESSIONAL CARE COMPANIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL-GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-691-3502
Mailing Address - Street 1:5121 WASHINGTON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6449
Mailing Address - Country:US
Mailing Address - Phone:706-691-3502
Mailing Address - Fax:
Practice Address - Street 1:4400 COLUMBIA ROAD SUITE 104
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907
Practice Address - Country:US
Practice Address - Phone:706-691-3502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health