Provider Demographics
NPI:1831737279
Name:HOME CARE OF NORTHWEST GEORGIA
Entity type:Organization
Organization Name:HOME CARE OF NORTHWEST GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:B
Authorized Official - Last Name:KOSATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-622-5602
Mailing Address - Street 1:PO BOX 1363
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-1363
Mailing Address - Country:US
Mailing Address - Phone:706-622-5602
Mailing Address - Fax:706-622-3766
Practice Address - Street 1:501 BROAD ST STE 303
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-2805
Practice Address - Country:US
Practice Address - Phone:706-622-5602
Practice Address - Fax:706-622-3766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health