Healthcare Provider Details

I. General information

NPI: 1124066865
Provider Name (Legal Business Name): UNITED HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 S MAIN ST SUITE B
CLEVELAND GA
30528-1409
US

IV. Provider business mailing address

211 E DOYLE ST
TOCCOA GA
30577-2960
US

V. Phone/Fax

Practice location:
  • Phone: 706-219-4799
  • Fax:
Mailing address:
  • Phone: 706-886-8493
  • Fax: 706-827-2048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number154-190
License Number StateGA

VIII. Authorized Official

Name: NEIL L PRUITT JR.
Title or Position: CHAIRMAN AND CEO
Credential:
Phone: 770-279-6200