Provider Demographics
NPI:1760111025
Name:GEORGIA FAMILY & CARE SERVICES, INC.
Entity Type:Organization
Organization Name:GEORGIA FAMILY & CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOLLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-837-1048
Mailing Address - Street 1:3312 NORTHSIDE DR STE #A-115 OFFICE #5
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2500
Mailing Address - Country:US
Mailing Address - Phone:478-714-3285
Mailing Address - Fax:
Practice Address - Street 1:3312 NORTHSIDE DR STE #A-115 OFFICE #5
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2500
Practice Address - Country:US
Practice Address - Phone:478-714-3285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty