Provider Demographics
NPI:1518541432
Name:GEORGIA HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:GEORGIA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:GARNETT
Authorized Official - Last Name:TOTIMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-898-9162
Mailing Address - Street 1:19449 RUSH ST NW
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-4132
Mailing Address - Country:US
Mailing Address - Phone:763-898-9162
Mailing Address - Fax:763-355-9273
Practice Address - Street 1:19449 RUSH ST NW
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-4132
Practice Address - Country:US
Practice Address - Phone:763-898-9162
Practice Address - Fax:763-355-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health