Provider Demographics
NPI:1063111490
Name:HOME MATTERS CAREGIVING GEORGIA LLC
Entity type:Organization
Organization Name:HOME MATTERS CAREGIVING GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-632-3899
Mailing Address - Street 1:2874 DORBY CLOSE NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-4546
Mailing Address - Country:US
Mailing Address - Phone:678-632-3899
Mailing Address - Fax:
Practice Address - Street 1:5825 GLENRIDGE DR BLDG 3
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5387
Practice Address - Country:US
Practice Address - Phone:678-632-3899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care