Provider Demographics
NPI:1891284170
Name:CHATTAHOOCHEE VALLEY HOME CARE
Entity Type:Organization
Organization Name:CHATTAHOOCHEE VALLEY HOME CARE
Other - Org Name:ACTI-KARE RESPONSIVE IN-HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-619-4519
Mailing Address - Street 1:239 JOHN HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:GA
Mailing Address - Zip Code:31826-4004
Mailing Address - Country:US
Mailing Address - Phone:706-610-4519
Mailing Address - Fax:706-243-4782
Practice Address - Street 1:239 JOHN HOWARD RD
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:GA
Practice Address - Zip Code:31826-4004
Practice Address - Country:US
Practice Address - Phone:706-610-4519
Practice Address - Fax:706-243-4782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA130-R-1876253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care