Provider Demographics
NPI:1124478995
Name:BEST CARE GEORGIA LLC
Entity type:Organization
Organization Name:BEST CARE GEORGIA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LENNIE
Authorized Official - Middle Name:ADNOID
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-954-7015
Mailing Address - Street 1:490 CRABAPPLE PL
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-5557
Mailing Address - Country:US
Mailing Address - Phone:478-254-4483
Mailing Address - Fax:478-254-4493
Practice Address - Street 1:490 CRABAPPLE PL
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-5557
Practice Address - Country:US
Practice Address - Phone:478-254-4483
Practice Address - Fax:478-254-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011-R-1599253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA011-R-1599OtherPROVIDER/SUPPLIER/CLIA INDENTIFICATION NUMBER