Provider Demographics
NPI:1124335542
Name:APP & M PERSONAL CARE HOME
Entity type:Organization
Organization Name:APP & M PERSONAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-884-5082
Mailing Address - Street 1:118 OLA B LN
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:GA
Mailing Address - Zip Code:31320-4501
Mailing Address - Country:US
Mailing Address - Phone:912-884-5082
Mailing Address - Fax:912-884-5082
Practice Address - Street 1:118 OLA B LN
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:GA
Practice Address - Zip Code:31320-4501
Practice Address - Country:US
Practice Address - Phone:912-884-5082
Practice Address - Fax:912-884-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA089-01-036-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health