Provider Demographics
NPI:1013194638
Name:HOME CARE SERVICES OF COLUMBUS LLC
Entity Type:Organization
Organization Name:HOME CARE SERVICES OF COLUMBUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-2780
Mailing Address - Street 1:5624 WHITESVILLE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3412
Mailing Address - Country:US
Mailing Address - Phone:706-507-2780
Mailing Address - Fax:706-507-2595
Practice Address - Street 1:5624 WHITESVILLE RD
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3412
Practice Address - Country:US
Practice Address - Phone:706-507-2780
Practice Address - Fax:706-507-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106-R-0037251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health