Provider Demographics
NPI:1871112342
Name:4 SEASONS HOME CARE, INC.
Entity type:Organization
Organization Name:4 SEASONS HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOU ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-419-5652
Mailing Address - Street 1:78 COLE ST NE STE 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2020
Mailing Address - Country:US
Mailing Address - Phone:770-419-5652
Mailing Address - Fax:770-419-8587
Practice Address - Street 1:78 COLE ST NE STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2020
Practice Address - Country:US
Practice Address - Phone:770-419-5652
Practice Address - Fax:770-419-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care