Provider Demographics
NPI:1306386750
Name:COMPLETE CARE SERVICES
Entity Type:Organization
Organization Name:COMPLETE CARE SERVICES
Other - Org Name:COMPLETE CARE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR/LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:229-894-7877
Mailing Address - Street 1:1205 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3851
Mailing Address - Country:US
Mailing Address - Phone:229-435-7764
Mailing Address - Fax:
Practice Address - Street 1:1205 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3851
Practice Address - Country:US
Practice Address - Phone:229-435-7764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 261Q00000X, 291U00000X
GA047-R-1538253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000921874CMedicaid