| NPI | 1609690312 |
|---|---|
| Former Legal Business Name | 123 GA HOME HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | DERRICK WHISBY Executive Director 470-554-6864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2024-11-09 |
| Last Update Date | 2024-11-09 |