Provider Demographics
NPI:1447509195
Name:ATLANTA CAREGIVERS AND ASSOCIATES LLC
Entity type:Organization
Organization Name:ATLANTA CAREGIVERS AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KSHAWNDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CNA, PCT
Authorized Official - Phone:678-683-0128
Mailing Address - Street 1:1254 BEAVER RUIN RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3005
Mailing Address - Country:US
Mailing Address - Phone:678-683-0128
Mailing Address - Fax:
Practice Address - Street 1:1254 BEAVER RUIN RD STE 305
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3005
Practice Address - Country:US
Practice Address - Phone:678-683-0128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health