Provider Demographics
NPI:1760190284
Name:CONGENIAL CARE PARTNERS LLC
Entity Type:Organization
Organization Name:CONGENIAL CARE PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAPHNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-940-3400
Mailing Address - Street 1:9360 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1268
Mailing Address - Country:US
Mailing Address - Phone:678-940-3400
Mailing Address - Fax:678-550-6552
Practice Address - Street 1:9360 PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1268
Practice Address - Country:US
Practice Address - Phone:678-940-3400
Practice Address - Fax:678-550-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care