Atlantic Homeaid Inc
Organization Active NPI Home Health Agency · Waycross, GA
NPI 1053392886 · NPPES record last updated Mar 15, 2024
Key facts
- NPI
- 1053392886
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 148R0001 (GA)
- Legal business name
- ATLANTIC HOMEAID INC
- Practice address
- 1710 Boulevard SQ Ste B
Waycross, GA 31501-8026 - Phone
- (912) 285-9924
- Fax
- (912) 285-0987
- NPI assigned
- Nov 9, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Joshua L Proffitt
- Title
- President
- Phone
- (337) 233-1307
National Provider Directory
Locations
1113 Clifford St
Waycross, GA 31501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 148R0001 | GA | Yes |
Addresses
Primary practice location
1710 Boulevard SQ Ste B
Waycross, GA 31501-8026
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00699971A | Other | GA | CCSP |
| 00699971C | Medicaid | GA |
Other names
- SunCrest Companion Services
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All providers in Waycross, GA · Home Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.