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General NPI Number Information
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NPI Number | 1164095527
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Entity Type | Organization
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Legal Business Name | GENTLE ROSE HOME CARE LLC
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 6550 VALLEY HILL DR SW
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City | MABLETON
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State | GA
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Zip | 30126-5152
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Country | US
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Telephone | 317-914-5778
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Fax |
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Provider Business Mailing Address
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Address Line | 6550 VALLEY HILL DR SW
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City | MABLETON
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State | GA
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Zip | 30126-5152
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Country | US
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Telephone | 317-914-5778
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Fax |
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Authorized Official
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Title or Position | OWNER/MANGER
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Name | ROBN YOUNG
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Credential |
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Telephone | 317-914-5778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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