Provider Demographics
NPI:1801484258
Name:RED RIVER HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:RED RIVER HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-222-6410
Mailing Address - Street 1:6110 ALTAMA AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-1827
Mailing Address - Country:US
Mailing Address - Phone:912-222-6410
Mailing Address - Fax:912-222-6410
Practice Address - Street 1:6110 ALTAMA AVE STE 112
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-1827
Practice Address - Country:US
Practice Address - Phone:912-222-6410
Practice Address - Fax:912-222-6410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RED RIVER HOMECARE OF THE GOLDEN ISLES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-31
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No347E00000XTransportation ServicesTransportation Broker
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA193117Medicaid