Provider Demographics
NPI:1740479864
Name:A CHANGE OF CARE
Entity type:Organization
Organization Name:A CHANGE OF CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING CONSULTANT/EXECUTIVE DIRECT
Authorized Official - Prefix:
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOLLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-680-8851
Mailing Address - Street 1:360 TWIN TENDRILS SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-7271
Mailing Address - Country:US
Mailing Address - Phone:404-680-8851
Mailing Address - Fax:
Practice Address - Street 1:360 TWIN TENDRILS SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-7271
Practice Address - Country:US
Practice Address - Phone:404-680-8851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168077311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home