Provider Demographics
NPI:1568157964
Name:COMMUNITY GROWTH ENTERPRISES INC.
Entity Type:Organization
Organization Name:COMMUNITY GROWTH ENTERPRISES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-584-6276
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30204-0512
Mailing Address - Country:US
Mailing Address - Phone:770-584-6276
Mailing Address - Fax:770-358-4745
Practice Address - Street 1:211 TIFT COLLEGE DR STE 201
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2337
Practice Address - Country:US
Practice Address - Phone:770-584-6276
Practice Address - Fax:478-994-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care