Provider Demographics
NPI:1417229873
Name:CAUGAN WELLSPRING INC
Entity Type:Organization
Organization Name:CAUGAN WELLSPRING INC
Other - Org Name:AARMAC CARE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWNETTE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:GANIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:678-601-1507
Mailing Address - Street 1:4220 FOX DEN DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4374
Mailing Address - Country:US
Mailing Address - Phone:678-601-1507
Mailing Address - Fax:
Practice Address - Street 1:4220 FOX DEN DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-4374
Practice Address - Country:US
Practice Address - Phone:678-601-1507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048-R-0935251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health