Provider Demographics
NPI:1144808320
Name:ATLANTA SECURE CARE SERVICES INC
Entity type:Organization
Organization Name:ATLANTA SECURE CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AFFIONG
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:IGBADUME
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:678-622-8099
Mailing Address - Street 1:135 POWERS FERRY RD SE STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-7541
Mailing Address - Country:US
Mailing Address - Phone:404-333-1396
Mailing Address - Fax:678-296-6971
Practice Address - Street 1:135 POWERS FERRY RD SE STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-7541
Practice Address - Country:US
Practice Address - Phone:404-333-1396
Practice Address - Fax:678-296-6971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health