Provider Demographics
NPI:1568706661
Name:CONNECTIONS TO CARE, LLC
Entity Type:Organization
Organization Name:CONNECTIONS TO CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-719-7555
Mailing Address - Street 1:105 HABERSHAM DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7341
Mailing Address - Country:US
Mailing Address - Phone:770-719-7555
Mailing Address - Fax:770-719-7533
Practice Address - Street 1:105 HABERSHAM DR
Practice Address - Street 2:SUITE C
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7341
Practice Address - Country:US
Practice Address - Phone:770-719-7555
Practice Address - Fax:770-719-7533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care