Healthcare Provider Details

I. General information

NPI: 1528976479
Provider Name (Legal Business Name): LAVISTA HOME CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 AUTUMN TRACE CT
MACON GA
31210-8024
US

IV. Provider business mailing address

243 AUTUMN TRACE CT
MACON GA
31210-8024
US

V. Phone/Fax

Practice location:
  • Phone: 478-258-3431
  • Fax: 478-258-3431
Mailing address:
  • Phone: 478-258-3431
  • Fax: 478-258-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFERY HODGES
Title or Position: OWNER
Credential:
Phone: 478-258-3431