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General NPI Number Information
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NPI Number | 1164920534
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Entity Type | Organization
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Legal Business Name | DOUBLE HEART PERSONAL CARE SERVICE LLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 1295 FRANKLIN DR SE
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City | MARIETTA
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State | GA
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Zip | 30067-8788
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Country | US
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Telephone | 470-255-7528
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Fax |
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Provider Business Mailing Address
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Address Line | 1295 FRANKLIN DR SE
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City | MARIETTA
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State | GA
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Zip | 30067-8788
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Country | US
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Telephone | 470-255-7528
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAKEISHA BARNES
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Credential |
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Telephone | 470-255-7528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 0028839152
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License Number State | GA
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