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General NPI Number Information
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NPI Number | 1184222440
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Entity Type | Organization
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Legal Business Name | PASSIONATE PEOPLE PERSONAL CARE LLC
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 6660 MABLETON PKWY SE APT 405
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City | MABLETON
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State | GA
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Zip | 30126-5399
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Country | US
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Telephone | 757-785-7625
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Fax |
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Provider Business Mailing Address
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Address Line | 6660 MABLETON PKWY SE APT 405
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City | MABLETON
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State | GA
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Zip | 30126-5399
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ONEIKA JACKSON
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Credential |
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Telephone | 757-785-7625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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