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General NPI Number Information
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NPI Number | 1679283329
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Entity Type | Organization
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Legal Business Name | GODFIDENT LOVE HOMECARE LLC
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 1564 HERRINGTON RD APT 2321
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7950
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Country | US
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Telephone | 678-707-3691
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Fax | 855-246-7452
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Provider Business Mailing Address
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Address Line | 1495 DULUTH HWY STE F1021
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5143
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Country | US
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Telephone | 800-447-9503
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Fax | 855-246-7452
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Authorized Official
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Title or Position | OWNER
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Name | MR. BOBBY PERDUE
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Credential |
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Telephone | 678-707-3691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care 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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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