Big Mommas' House Pch INC

NPI #1578892774 in Lithonia, Georgia

Provider Information

NPI Number: 1578892774
Entity Type: Organization
Organization Name: Big Mommas' House Pch INC
Primary Specialty: Home Health
Enumeration Date: Dec 17, 2009
Last Updated: Dec 17, 2009

Practice Location

Address: 4791 GOLOD WAY
City: Lithonia
State: Georgia
ZIP Code: 30038-6297
Phone: (678) 418-3007

Authorized Official

Name: HANIYYAH INTARSAR ABDUL-AZIZ
Title: CEO
Phone: (678) 418-3007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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