Provider Demographics
NPI:1104171420
Name:WEAVERS BUSINESS SERVICES INC
Entity type:Organization
Organization Name:WEAVERS BUSINESS SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-978-1210
Mailing Address - Street 1:803 W OGEECHEE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-8696
Mailing Address - Country:US
Mailing Address - Phone:912-564-1118
Mailing Address - Fax:912-564-1119
Practice Address - Street 1:104 E TELEPHONE ST
Practice Address - Street 2:104 E TELEPHONE ST
Practice Address - City:SYLVANIA
Practice Address - State:GA
Practice Address - Zip Code:30467-1959
Practice Address - Country:US
Practice Address - Phone:912-564-2513
Practice Address - Fax:912-564-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QA0600X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care