MEDICARE: CARE LIKE HOME

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1477368140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE LIKE HOME

Provider Business Mailing Address
First Line	:	166 RIDGECREST LOOP
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36301-6048
Country	:	US
Telephone Number	:	205-643-8158
Fax Number	:	205-876-8246

Provider Business Practice Location Address
First Line	:	109 W TROY ST # 1215
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-4516
Country	:	US
Telephone Number	:	205-643-8158
Fax Number	:	205-876-8246

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LAQUANTA BURKS BRIDGES
Credential	:
Telephone Number	:	205-643-8158

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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Directions to “CARE LIKE HOME ” Practice Location

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