Healthcare Provider Details

I. General information

NPI: 1962741751
Provider Name (Legal Business Name): LOVING HANDS HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 CUMBERLAND BOULEVARD SUITE 500
ATLANTA GA
30339
US

IV. Provider business mailing address

3330 CUMBERLAND BOULEVARD SUITE 500
ATLANTA GA
30339
US

V. Phone/Fax

Practice location:
  • Phone: 404-520-2719
  • Fax:
Mailing address:
  • Phone: 404-910-4209
  • Fax: 404-910-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number12044976
License Number StateGA

VIII. Authorized Official

Name: PATRICIA DUBE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 404-910-4209