Provider Demographics
NPI:1083840805
Name:TOP OF THE LINE HEALTHCARE
Entity Type:Organization
Organization Name:TOP OF THE LINE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:678-896-7486
Mailing Address - Street 1:4818 MITCHELLS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-6631
Mailing Address - Country:US
Mailing Address - Phone:678-289-2487
Mailing Address - Fax:678-289-2487
Practice Address - Street 1:4818 MITCHELLS RIDGE DR
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-6631
Practice Address - Country:US
Practice Address - Phone:678-289-2487
Practice Address - Fax:678-289-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-0513253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA841707583AMedicaid