Provider Demographics
NPI:1164824322
Name:SURE CARE
Entity Type:Organization
Organization Name:SURE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:JANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCLAREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-755-2832
Mailing Address - Street 1:110 SYLVAN LOOP
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7439
Mailing Address - Country:US
Mailing Address - Phone:678-755-2832
Mailing Address - Fax:
Practice Address - Street 1:110 SYLVAN LOOP
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7439
Practice Address - Country:US
Practice Address - Phone:678-755-2832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home