Provider Demographics
NPI:1578067088
Name:HERITAGEFIRST HOME CARE OF CENTRAL GEORGIA INC.
Entity Type:Organization
Organization Name:HERITAGEFIRST HOME CARE OF CENTRAL GEORGIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:FLOURNOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-234-0070
Mailing Address - Street 1:1277 TWIN PINE RD
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-4231
Mailing Address - Country:US
Mailing Address - Phone:478-234-0070
Mailing Address - Fax:
Practice Address - Street 1:1930 ROBIN CIR
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2053
Practice Address - Country:US
Practice Address - Phone:478-234-0070
Practice Address - Fax:800-537-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005R1861251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health