Provider Demographics
NPI:1487231452
Name:GEORGIA FAMILY HOME CARE, LLC
Entity Type:Organization
Organization Name:GEORGIA FAMILY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMEIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-251-9156
Mailing Address - Street 1:70 PUMPING STATION RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:GA
Mailing Address - Zip Code:31087-1206
Mailing Address - Country:US
Mailing Address - Phone:478-251-9676
Mailing Address - Fax:
Practice Address - Street 1:1943 N JEFFERSON ST NE STE B5
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-3090
Practice Address - Country:US
Practice Address - Phone:478-251-9676
Practice Address - Fax:478-454-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care