Provider Demographics
NPI:1548714843
Name:AMAZING CARE AGENCY INC
Entity type:Organization
Organization Name:AMAZING CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-789-4629
Mailing Address - Street 1:223 SCENIC HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5603
Mailing Address - Country:US
Mailing Address - Phone:678-789-4629
Mailing Address - Fax:
Practice Address - Street 1:223 SCENIC HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5603
Practice Address - Country:US
Practice Address - Phone:678-789-4629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251J00000X, 314000000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility