Provider Demographics
NPI:1043680267
Name:GADDIEL HOMECARE SERVICES INC.
Entity type:Organization
Organization Name:GADDIEL HOMECARE SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:APURI-NDEPEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-559-5312
Mailing Address - Street 1:3300 HOLCOMB BRIDGE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3298
Mailing Address - Country:US
Mailing Address - Phone:770-559-5312
Mailing Address - Fax:770-559-3238
Practice Address - Street 1:3300 HOLCOMB BRIDGE RD STE 260
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-3298
Practice Address - Country:US
Practice Address - Phone:770-559-5312
Practice Address - Fax:770-559-3238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003246058AMedicaid