Provider Demographics
NPI:1134426828
Name:GOD'S WAY HEALTH CARE SERVICE LLC
Entity type:Organization
Organization Name:GOD'S WAY HEALTH CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:678-369-7380
Mailing Address - Street 1:PO BOX 1631
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-8010
Mailing Address - Country:US
Mailing Address - Phone:678-369-7380
Mailing Address - Fax:866-231-9331
Practice Address - Street 1:1218 FAIRBURN RD SW
Practice Address - Street 2:SUITE 102
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2117
Practice Address - Country:US
Practice Address - Phone:678-369-7380
Practice Address - Fax:866-231-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-0648253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care