Healthcare Provider Details

I. General information

NPI: 1083423388
Provider Name (Legal Business Name): THE GUESTS PRIVATE PERSONAL CARE PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5697 MILLER GROVE RD
LITHONIA GA
30058-4868
US

IV. Provider business mailing address

3418 SPRING PLACE CT
LOGANVILLE GA
30052-5292
US

V. Phone/Fax

Practice location:
  • Phone: 678-704-5008
  • Fax:
Mailing address:
  • Phone: 678-704-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHAWANDA BIGBY
Title or Position: OWNER
Credential:
Phone: 678-704-5008