Provider Demographics
NPI:1578339198
Name:SAHARA GEORGIA HOME CARE LLC
Entity Type:Organization
Organization Name:SAHARA GEORGIA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:A
Authorized Official - Last Name:NASIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-350-3857
Mailing Address - Street 1:1400 BUFORD HWY STE L6-B
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8721
Mailing Address - Country:US
Mailing Address - Phone:470-350-3857
Mailing Address - Fax:678-482-1122
Practice Address - Street 1:1400 BUFORD HWY STE L6-B
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8721
Practice Address - Country:US
Practice Address - Phone:470-350-3857
Practice Address - Fax:678-482-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care