Healthcare Provider Details

I. General information

NPI: 1346002623
Provider Name (Legal Business Name): VERA LOVING CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 INSPERON DR
GROVETOWN GA
30813-0598
US

IV. Provider business mailing address

2047 CHANUPA CT
GROVETOWN GA
30813-3817
US

V. Phone/Fax

Practice location:
  • Phone: 706-305-1576
  • Fax: 706-925-5723
Mailing address:
  • Phone: 706-910-3580
  • Fax: 706-925-5723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: QUANISHA ALIYAH VERA
Title or Position: ADMINISTRATOR
Credential:
Phone: 706-910-3580