Provider Demographics
NPI:1760222426
Name:FULLFEEL CARE & CONCIERGE LLC
Entity type:Organization
Organization Name:FULLFEEL CARE & CONCIERGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JADA
Authorized Official - Middle Name:LACOLE
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:404-664-3873
Mailing Address - Street 1:224 LONG NEEDLE DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-1650
Mailing Address - Country:US
Mailing Address - Phone:404-664-3873
Mailing Address - Fax:
Practice Address - Street 1:224 LONG NEEDLE DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-1650
Practice Address - Country:US
Practice Address - Phone:404-664-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health