Provider Demographics
NPI:1134467103
Name:NORTH GA HOME CARE
Entity Type:Organization
Organization Name:NORTH GA HOME CARE
Other - Org Name:SYNERGY HOME CARE OF NORTH GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-374-3999
Mailing Address - Street 1:2078 TERON TRCE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1604
Mailing Address - Country:US
Mailing Address - Phone:770-783-2323
Mailing Address - Fax:770-872-0913
Practice Address - Street 1:2078 TERON TRCE
Practice Address - Street 2:SUITE 250
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1604
Practice Address - Country:US
Practice Address - Phone:770-783-2323
Practice Address - Fax:770-872-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067R0723253Z00000X
GA008R0722253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care