Provider Demographics
NPI:1770031478
Name:NORTHWEST GA HOME CARE/ DBA RIGHT AT HOME
Entity Type:Organization
Organization Name:NORTHWEST GA HOME CARE/ DBA RIGHT AT HOME
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-290-7701
Mailing Address - Street 1:11 JOHN DAVENPORT DR NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2535
Mailing Address - Country:US
Mailing Address - Phone:706-290-7701
Mailing Address - Fax:706-290-7702
Practice Address - Street 1:11 JOHN DAVENPORT DR NW
Practice Address - Street 2:SUITE B
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2535
Practice Address - Country:US
Practice Address - Phone:706-290-7701
Practice Address - Fax:706-290-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
GA057-R-0017251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA899519694AMedicaid