Provider Demographics
NPI:1841622156
Name:GREATER CARE SERVICES, INC
Entity type:Organization
Organization Name:GREATER CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:706-231-3720
Mailing Address - Street 1:2635 CORNING ST
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-6540
Mailing Address - Country:US
Mailing Address - Phone:706-798-9489
Mailing Address - Fax:
Practice Address - Street 1:2329 BASSWOOD DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-9482
Practice Address - Country:US
Practice Address - Phone:706-790-0143
Practice Address - Fax:706-790-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA992279260A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA992279260AMedicaid