Provider Demographics
NPI:1376176453
Name:ATLANTA ELDERLY HOME CARE
Entity Type:Organization
Organization Name:ATLANTA ELDERLY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SATWANT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SEWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-797-7342
Mailing Address - Street 1:6251 SMITHPOINTE DR.
Mailing Address - Street 2:SUITE 200 BLDG B
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092
Mailing Address - Country:US
Mailing Address - Phone:678-924-0037
Mailing Address - Fax:
Practice Address - Street 1:6251 SMITHPOINTE DR.
Practice Address - Street 2:SUITE 200 BLDG B
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092
Practice Address - Country:US
Practice Address - Phone:678-924-0037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003130484BMedicaid
GA003130484AMedicaid