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SUNCREST HOME HEALTH OF SOUTH GA INC. NPI 1457583718


NPI Information

NPI: 1457583718
Provider Name: SUNCREST HOME HEALTH OF SOUTH GA, INC.

Doing Business As: SUNCREST HOME HEALTH

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 11D0879666

Address:
1221 W 4TH ST STE 7
ADEL, GA
ZIP 31620
Phone: (229) 896-8177
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SUNCREST HOME HEALTH OF SOUTH GA, INC. is a home health in Adel, GA. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. SUNCREST HOME HEALTH OF SOUTH GA, INC. NPI is 1457583718. The provider is registered as an organization entity type.
The provider Is Doing Business As Suncrest Home Health.

The provider's business location address is:

1221 W 4TH ST STE 7
ADEL, GA
ZIP 31620-906
Phone: (229) 896-8177
Fax: (229) 296-7880

The provider's authorized official is Nicholas Gachassin .
The authorized official title is Secretary / Treasurer and has the following contact phone number (337) 233-1307.

The CLIA number assigned to this NPI record is 11D0879666 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2009 and was last updated on 8/14/2020.


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
1251E00000XHome Health037-101GEORGIAYes

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
100887983AMEDICAIDGEORGIA

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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