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SOUTHERN CRESCENT HOME CARE NPI 1295065175


NPI Information

NPI: 1295065175
Provider Name: SOUTHERN CRESCENT HOME CARE
Classification: In Home Supportive Care - 253Z00000X
Entity Type: Organization
Address:
1351 GRINDENWALD DR
JONESBORO, GA
ZIP 30238
Phone: (678) 360-6003
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SOUTHERN CRESCENT HOME CARE is an in home supportive care in Jonesboro, GA. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. SOUTHERN CRESCENT HOME CARE NPI is 1295065175. The provider is registered as an organization entity type.

The provider's business location address is:

1351 GRINDENWALD DR
JONESBORO, GA
ZIP 30238-001
Phone: (678) 360-6003
Fax: (770) 472-0107

The provider's authorized official is Jonathan Onyibo Moh .
The authorized official title is Administrator and has the following contact phone number (678) 360-6003.

The enumeration date for this NPI number is 12/28/2009 and was last updated on 12/28/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive Care031-R-0360GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1164763686AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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