Provider Demographics
NPI:1376951178
Name:NORTH GEORGIA SENIOR HOME CARE LLC
Entity Type:Organization
Organization Name:NORTH GEORGIA SENIOR HOME CARE LLC
Other - Org Name:BRIGHTSTAR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-450-1777
Mailing Address - Street 1:315 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2605
Mailing Address - Country:US
Mailing Address - Phone:678-450-1777
Mailing Address - Fax:678-450-1999
Practice Address - Street 1:315 ALLEN ST
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2605
Practice Address - Country:US
Practice Address - Phone:678-450-1777
Practice Address - Fax:678-450-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069-R-0767251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health