Provider Demographics
NPI:1518745645
Name:GOD VESSELS
Entity Type:Organization
Organization Name:GOD VESSELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:MACHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-615-7672
Mailing Address - Street 1:164 LUKE CV
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-2387
Mailing Address - Country:US
Mailing Address - Phone:404-615-7672
Mailing Address - Fax:770-731-0967
Practice Address - Street 1:164 LUKE CV
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-2387
Practice Address - Country:US
Practice Address - Phone:404-615-7672
Practice Address - Fax:770-731-0967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health