Healthcare Provider Details
I. General information
NPI: 1689131724
Provider Name (Legal Business Name): FAVOR HOME HEALTH CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
51 GALLERY CT
ACWORTH GA
30101-2709
US
IV. Provider business mailing address
51 GALLERY CT
ACWORTH GA
30101-2709
US
V. Phone/Fax
- Phone: 678-508-5356
- Fax:
- Phone: 678-508-5356
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ULCY
MONEREAU-JULES
Title or Position: CEO/CLINICAL DIRECTOR
Credential: RN
Phone: 678-508-5356