Provider Demographics
NPI:1760483606
Name:NORTH GEORGIA CARE SERVICES, INC
Entity type:Organization
Organization Name:NORTH GEORGIA CARE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF BOARD
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:706-378-0940
Mailing Address - Street 1:505 N 5TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2822
Mailing Address - Country:US
Mailing Address - Phone:706-291-0521
Mailing Address - Fax:706-234-3508
Practice Address - Street 1:505 N 5TH AVE SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2822
Practice Address - Country:US
Practice Address - Phone:706-291-0521
Practice Address - Fax:706-234-3508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-057-1743314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00140984AMedicaid
GA00140984AMedicaid