Active NPI
Friendly Care Agency LLC
- In Home Supportive Care Agency
- Macon, GA
National Provider Identifier
1194172783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- FRIENDLY CARE AGENCY LLC
- Practice address
- 4480 Riverside Dr Ste 20
Macon, GA 31210-1363 - Phone
- (478) 216-8250
- NPI assigned
- May 24, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Quantez D Parks
- Title
- Assistant Administrator
- Phone
- (478) 216-8250
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
4480 Riverside Dr Ste 20
Macon, GA 31210-1363
Mailing address
4480 Riverside Dr Ste 20
Macon, GA 31210-1363
Phone (478) 216-8250
National Provider Directory
National Provider DirectoryLocations
4480 Riverside Dr
Ste 20
Macon, GA 31210
Phone (478) 216-8250
836 Walnut St
Ste 101
Macon, GA 31201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1464048000000",
"number": "1194172783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4480 RIVERSIDE DR STE 20",
"city": "MACON",
"state": "GA",
"postal_code": "312101363",
"telephone_number": "478-216-8250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4480 RIVERSIDE DR STE 20",
"city": "MACON",
"state": "GA",
"postal_code": "312101363",
"telephone_number": "478-216-8250"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRIENDLY CARE AGENCY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-24",
"last_updated": "2016-05-24",
"status": "A",
"authorized_official_last_name": "PARKS",
"authorized_official_first_name": "QUANTEZ",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
"authorized_official_telephone_number": "478-216-8250",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.