Provider Demographics
NPI:1700415189
Name:GEORGIA CARE AT HOME
Entity Type:Organization
Organization Name:GEORGIA CARE AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELISA BETH
Authorized Official - Last Name:DEPERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-280-6206
Mailing Address - Street 1:623 PETERS ST
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-3135
Mailing Address - Country:US
Mailing Address - Phone:706-280-6206
Mailing Address - Fax:
Practice Address - Street 1:717 S WALL ST STE C
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2649
Practice Address - Country:US
Practice Address - Phone:706-280-6206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care