MEDICARE: WE CARE HOME CARE 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669981536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WE CARE HOME CARE LLC

Provider Business Mailing Address
First Line	:	126 ENTERPRISE PATH STE 103
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-2655
Country	:	US
Telephone Number	:	770-681-0517
Fax Number	:	770-703-6417

Provider Business Practice Location Address
First Line	:	126 ENTERPRISE PATH STE 103
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-2655
Country	:	US
Telephone Number	:	770-681-0517
Fax Number	:	770-703-6417

Authorized Official
Title or Position	:	OWNER
Name	:	JADAWNYA D BOSTOCK
Credential	:
Telephone Number	:	770-681-0517

Provider Enumeration Date	:	09/23/2017
Last Update Date	:	07/21/2022

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Directions to “WE CARE HOME CARE LLC ” Practice Location

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