Provider Demographics
NPI:1477189132
Name:VETERANS AT HOME CARE
Entity Type:Organization
Organization Name:VETERANS AT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-246-0698
Mailing Address - Street 1:499 CARLTON LN
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-8109
Mailing Address - Country:US
Mailing Address - Phone:404-246-0698
Mailing Address - Fax:
Practice Address - Street 1:499 CARLTON LN
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:GA
Practice Address - Zip Code:30268-8109
Practice Address - Country:US
Practice Address - Phone:404-246-0698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health