Provider Demographics
NPI:1619539020
Name:CARE4ALL COMMUNITY CARE, INC.
Entity Type:Organization
Organization Name:CARE4ALL COMMUNITY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SMART
Authorized Official - Middle Name:
Authorized Official - Last Name:GUOBADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-397-4996
Mailing Address - Street 1:1174 MCKENDREE CHURCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6000
Mailing Address - Country:US
Mailing Address - Phone:678-719-9677
Mailing Address - Fax:888-620-3790
Practice Address - Street 1:1174 MCKENDREE CHURCH RD STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-6000
Practice Address - Country:US
Practice Address - Phone:678-719-9677
Practice Address - Fax:888-620-3790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003216332BMedicaid
GA003216332AMedicaid