Provider Demographics
NPI:1346550670
Name:CELESTIAL CARE COMPANIONS LLC
Entity Type:Organization
Organization Name:CELESTIAL CARE COMPANIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:LAVERNE
Authorized Official - Last Name:LOMAX
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:404-426-1028
Mailing Address - Street 1:1177 CONSTITUTION RD SE APT L4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-6840
Mailing Address - Country:US
Mailing Address - Phone:404-426-1028
Mailing Address - Fax:
Practice Address - Street 1:1177 CONSTITUTION RD SE APT L4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-6840
Practice Address - Country:US
Practice Address - Phone:404-426-1028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10039349372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty