Provider Demographics
NPI:1265772438
Name:ENGLEWOOD HEALTH CARE, INC.
Entity type:Organization
Organization Name:ENGLEWOOD HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:229-883-4844
Mailing Address - Street 1:907 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2210
Mailing Address - Country:US
Mailing Address - Phone:229-883-4844
Mailing Address - Fax:229-883-3171
Practice Address - Street 1:907 NORTH MADISON STREET
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1743
Practice Address - Country:US
Practice Address - Phone:229-883-4844
Practice Address - Fax:229-883-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000341899B385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000341899BMedicaid