NPIMap

Organization Active NPI

Georgia Specialty Care Staffing Agency

  • In Home Supportive Care Agency
  • Lagrange, GA
National Provider Identifier
1770847725
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GEORGIA SPECIALTY CARE STAFFING AGENCY
Practice address
307 S Lewis St Ste C
Lagrange, GA 30240-3169
Phone
(706) 756-9510
NPI assigned
Jun 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Ms. Katryna Delmara Wicks, RN
Title
Ceo
Phone
(706) 756-9510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

307 S Lewis St Ste C
Lagrange, GA 30240-3169

Mailing address

307 S Lewis St Ste C
Lagrange, GA 30240-3169
Phone (706) 756-9510

National Provider Directory

National Provider Directory

Locations

307 S Lewis St
Ste C
Lagrange, GA 30240
Phone (706) 756-9510

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1770847725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S LEWIS ST STE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403169",
            "telephone_number": "706-756-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S LEWIS ST STE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403169",
            "telephone_number": "706-756-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SPECIALTY CARE STAFFING AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "WICKS",
        "authorized_official_first_name": "KATRYNA",
        "authorized_official_middle_name": "DELMARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-756-9510",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.