Provider Demographics
NPI:1932725702
Name:EKAA CARE AND SUPPORT PROVIDER
Entity Type:Organization
Organization Name:EKAA CARE AND SUPPORT PROVIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:404-663-5578
Mailing Address - Street 1:332 BRENTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-4261
Mailing Address - Country:US
Mailing Address - Phone:404-663-5578
Mailing Address - Fax:
Practice Address - Street 1:332 BRENTFORD AVE
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-4261
Practice Address - Country:US
Practice Address - Phone:404-663-5578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health