MEDICARE: HOME CARE PROMISE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1023681517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME CARE PROMISE LLC

Provider Business Mailing Address
First Line	:	3343 PEACHTREE RD NE STE 145
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1427
Country	:	US
Telephone Number	:	404-590-2246
Fax Number	:

Provider Business Practice Location Address
First Line	:	3343 PEACHTREE RD NE STE 145
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1427
Country	:	US
Telephone Number	:	404-590-2246
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TOMAS HAGOS
Credential	:
Telephone Number	:	404-590-2246

Provider Enumeration Date	:	07/21/2021
Last Update Date	:	07/21/2021

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Directions to “HOME CARE PROMISE LLC ” Practice Location

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