Healthcare Provider Details

I. General information

NPI: 1952265084
Provider Name (Legal Business Name): LUXURY PRIVATE HOMECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7247 CONFEDERATE LN
VILLA RICA GA
30180-9614
US

IV. Provider business mailing address

7247 CONFEDERATE LN
VILLA RICA GA
30180-9614
US

V. Phone/Fax

Practice location:
  • Phone: 770-802-0847
  • Fax:
Mailing address:
  • Phone: 770-802-0847
  • Fax:

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: LASHANNON MARIE NORTH
Title or Position: CEO
Credential: CNA
Phone: 770-802-0847