Provider Demographics
NPI:1659937829
Name:AMAZING SOUTHERN GIRLS HOME CARE,LLC
Entity Type:Organization
Organization Name:AMAZING SOUTHERN GIRLS HOME CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-736-4018
Mailing Address - Street 1:2295 HENRY CLOWER BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5707
Mailing Address - Country:US
Mailing Address - Phone:678-736-4018
Mailing Address - Fax:470-282-3392
Practice Address - Street 1:2295 HENRY CLOWER BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5707
Practice Address - Country:US
Practice Address - Phone:678-736-4018
Practice Address - Fax:470-282-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care