Provider Demographics
NPI:1760754113
Name:CATER HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:CATER HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-648-7532
Mailing Address - Street 1:2183 SALEM RD SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1803
Mailing Address - Country:US
Mailing Address - Phone:770-648-7532
Mailing Address - Fax:678-806-5555
Practice Address - Street 1:2183 SALEM RD SE
Practice Address - Street 2:SUITE A
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1803
Practice Address - Country:US
Practice Address - Phone:770-648-7532
Practice Address - Fax:678-806-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA075-R-1076Medicaid
GA003142254AOther003142256A PEACH CARE FOR KIDS