Provider Demographics
NPI:1083733521
Name:JM HOME CARE SERVICES
Entity Type:Organization
Organization Name:JM HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-873-8290
Mailing Address - Street 1:6722 HIGHWAY 85
Mailing Address - Street 2:SUITE 6
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2385
Mailing Address - Country:US
Mailing Address - Phone:770-873-8290
Mailing Address - Fax:770-996-7720
Practice Address - Street 1:6722 HIGHWAY 85
Practice Address - Street 2:SUITE 6
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2385
Practice Address - Country:US
Practice Address - Phone:770-873-8290
Practice Address - Fax:770-996-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031R0036251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA619456047AMedicaid