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NPI Code Detail

MEDICARE: COMMITTED ANGELS HOME CARE LLC

MEDICARE: COMMITTED ANGELS 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1720878986
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMITTED ANGELS HOME CARE LLC
Provider Business Mailing Address
First Line : 2635 HIGH ST SW
Second Line :
City : CONYERS
State : GA
Zip : 30094-6848
Country : US
Telephone Number : 470-257-8515
Fax Number :
Provider Business Practice Location Address
First Line : 3750 PEACHTREE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-1385
Country : US
Telephone Number : 367-379-3974
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : JACQUELINE DOROTHY REID PERRY
Credential :
Telephone Number : 678-397-3674
Provider Enumeration Date : 05/10/2025
Last Update Date : 05/10/2025

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Directions to “COMMITTED ANGELS HOME CARE LLC ” Practice Location

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