Provider Demographics
NPI:1386054872
Name:HODGSON CAREGIVERS, LLC
Entity type:Organization
Organization Name:HODGSON CAREGIVERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HODGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-442-2154
Mailing Address - Street 1:294 S MAIN ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7918
Mailing Address - Country:US
Mailing Address - Phone:770-442-2154
Mailing Address - Fax:770-442-2507
Practice Address - Street 1:294 S MAIN ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7918
Practice Address - Country:US
Practice Address - Phone:770-442-2154
Practice Address - Fax:770-442-2507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-0256253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003119501Medicaid