Provider Demographics
NPI:1982910261
Name:MORE CARE II INC
Entity Type:Organization
Organization Name:MORE CARE II INC
Other - Org Name:FIRST IMEX CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OWOLABI
Authorized Official - Suffix:
Authorized Official - Credentials:MA,BS,LPN
Authorized Official - Phone:706-360-1813
Mailing Address - Street 1:5038 STORY MILL RD
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-4814
Mailing Address - Country:US
Mailing Address - Phone:706-360-1813
Mailing Address - Fax:706-790-9925
Practice Address - Street 1:5038 STORY MILL RD
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-4814
Practice Address - Country:US
Practice Address - Phone:706-360-1813
Practice Address - Fax:706-790-9925
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST IMEX CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA326100127D320800000X, 343800000X
GA326100127B320900000X
GA326100127C347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA236100127AMedicaid
GA326100127BMedicaid
GA326100127CMedicaid
GA326100127DMedicaid