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General NPI Number Information
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NPI Number | 1457081200
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Entity Type | Organization
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Legal Business Name | PURE HEARTS PERSONAL CARE HOME LLC
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 5404 MCEVER RD
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City | OAKWOOD
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State | GA
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Zip | 30566-3505
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Country | US
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Telephone | 770-965-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 MCEVER RD
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City | OAKWOOD
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State | GA
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Zip | 30566-3505
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Country | US
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Telephone | 770-965-7000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SANDRA HUGHES
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Credential |
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Telephone | 770-882-3498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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