Healthcare Provider Details

I. General information

NPI: 1144064734
Provider Name (Legal Business Name): REGAL HOME SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5832 WELLBORN OAKS CT
LITHNONIA GA
30058
US

IV. Provider business mailing address

PO BOX 484
WINNSBORO SC
29180-0484
US

V. Phone/Fax

Practice location:
  • Phone: 833-471-0026
  • Fax: 803-815-1308
Mailing address:
  • Phone: 803-402-9566
  • Fax: 803-815-1308

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
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LAKISHA IRBY
Title or Position: ADMINISTRATOR
Credential:
Phone: 803-402-9566