Provider Demographics
NPI:1578098836
Name:SIGNIFICANT COMPANION HOME CARE LLC
Entity Type:Organization
Organization Name:SIGNIFICANT COMPANION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-927-4124
Mailing Address - Street 1:1246 MILL CREST WALK NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4244
Mailing Address - Country:US
Mailing Address - Phone:678-927-4124
Mailing Address - Fax:
Practice Address - Street 1:1246 MILL CREST WALK NW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4244
Practice Address - Country:US
Practice Address - Phone:678-927-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care