Provider Demographics
NPI:1831695139
Name:S&S COMPANION CARE OF FOREST CITY NC LLC
Entity type:Organization
Organization Name:S&S COMPANION CARE OF FOREST CITY NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-551-2006
Mailing Address - Street 1:302 W I PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-5002
Mailing Address - Country:US
Mailing Address - Phone:470-551-2006
Mailing Address - Fax:
Practice Address - Street 1:838 OAKLAND RD
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-2163
Practice Address - Country:US
Practice Address - Phone:828-287-5799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health