Provider Demographics
NPI:1376911750
Name:ALLWELL HEALTHCARE OF GEORGIA INC
Entity Type:Organization
Organization Name:ALLWELL HEALTHCARE OF GEORGIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:ONOYONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-923-4637
Mailing Address - Street 1:4171 MARIETTA ST
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2696
Mailing Address - Country:US
Mailing Address - Phone:678-923-4637
Mailing Address - Fax:
Practice Address - Street 1:4171 MARIETTA ST
Practice Address - Street 2:SUITE 300B
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2696
Practice Address - Country:US
Practice Address - Phone:678-923-4637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-1322251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health