Provider Demographics
NPI:1073682936
Name:ADAMS' LOVING PRO HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:ADAMS' LOVING PRO HOME HEALTH CARE INC.
Other - Org Name:ADAM'S LOVING PRO HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:FISHER
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-449-4872
Mailing Address - Street 1:1277 HWY 82 WEST
Mailing Address - Street 2:121
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763
Mailing Address - Country:US
Mailing Address - Phone:229-434-8044
Mailing Address - Fax:229-434-8042
Practice Address - Street 1:1277 HWY 82 WEST
Practice Address - Street 2:121
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763
Practice Address - Country:US
Practice Address - Phone:229-434-8044
Practice Address - Fax:229-434-8042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047R0018251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000782053AMedicaid