Provider Demographics
NPI:1417944075
Name:CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY
Entity Type:Organization
Organization Name:CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY
Other - Org Name:LANIER HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HOME HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-756-1950
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:5700 CHIPLEY VILLAGE
Mailing Address - City:PINE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:31822-0475
Mailing Address - Country:US
Mailing Address - Phone:706-663-0988
Mailing Address - Fax:706-663-0687
Practice Address - Street 1:US HWY 27 AND 354
Practice Address - Street 2:5700 CHIPLEY VILLAGE
Practice Address - City:PINE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:31822-0475
Practice Address - Country:US
Practice Address - Phone:706-663-0988
Practice Address - Fax:706-663-0687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA072-261-H251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA117318Medicare ID - Type Unspecified