Sydal Enterprises, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

075-R-0707 Issued in GA

Legal business name

SYDAL ENTERPRISES, LLC

Practice address

330 Kerrith Dr
Stockbridge, GA 30281-4278

Phone

(678) 764-6204

Fax

(678) 400-0735

NPI assigned

May 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Sylvie Godwin

Title

Owner/Administrator

Phone

(678) 764-6204

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1720423320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 KERRITH DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814278",
            "telephone_number": "678-764-6204",
            "fax_number": "678-400-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 KERRITH DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814278",
            "telephone_number": "678-764-6204",
            "fax_number": "678-400-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYDAL ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "SYLVIE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "678-764-6204",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "075-R-0707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.