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Big Mommas' House Pch INC

Home Health in Lithonia, GA. Organization (NPI-2).

NPI number1578892774
StatusActive
Last updated in NPPESDec 17, 2009

Details

NPI
1578892774
Entity type
Organization (NPI-2)
Legal business name
Big Mommas' House Pch INC
Organization subpart
No
Enumeration date
Dec 17, 2009
Last updated
Dec 17, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health––Yes

Practice location

4791 Golod Way
Lithonia, GA 30038-6297

Phone 678-418-3007 · Fax 678-418-9958

Mailing address

4791 Golod Way
Lithonia, GA 30038-6297

Phone 678-418-3007 · Fax 678-418-9958

Authorized official

Haniyyah Intarsar Abdul-Aziz
Ceo
6784183007

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