Proactive Home Care Services, Inc.

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

005-R-0386 Issued in GA

Legal business name

PROACTIVE HOME CARE SERVICES, INC.

Practice address

2624 Irwinton Rd
Milledgeville, GA 31061-9762

Phone

(478) 452-2293

Fax

(478) 452-2293

NPI assigned

Apr 28, 2011

Organization subpart

No

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

Authorized official

Name

Mr. George NMN Barlow

Title

Administrator

Phone

(478) 452-2293

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1902197650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 IRWINTON RD",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310619762",
            "telephone_number": "478-452-2293",
            "fax_number": "478-452-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 IRWINTON RD",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310619762",
            "telephone_number": "478-452-2293",
            "fax_number": "478-452-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HOME CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-28",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "BARLOW",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "NMN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-452-2293",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "GA",
            "license": "005-R-0386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.