Healthcare Provider Details

I. General information

NPI: 1023478005
Provider Name (Legal Business Name): TRUSTED HANDS SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 OLD ROSWELL ROAD SUITE 240
ROSWELL GA
30076-1490
US

IV. Provider business mailing address

760 OLD ROSWELL ROAD SUITE 240
ROSWELL GA
30076-1490
US

V. Phone/Fax

Practice location:
  • Phone: 404-490-0848
  • Fax: 404-907-1277
Mailing address:
  • Phone: 404-490-0848
  • Fax: 404-907-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number060-R-1357
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number060-R-1357
License Number StateGA

VIII. Authorized Official

Name: MONIQUE COLLINS
Title or Position: ADMINISTRATOR DIRECTOR
Credential:
Phone: 404-490-0848