Provider Demographics
NPI:1073958252
Name:VAULEET'S PERSONAL CARE HOME, LLC
Entity Type:Organization
Organization Name:VAULEET'S PERSONAL CARE HOME, LLC
Other - Org Name:VAULEET'S HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEITCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:770-865-1509
Mailing Address - Street 1:2811 BLUE GRASS LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-3310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2811 BLUE GRASS LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-3310
Practice Address - Country:US
Practice Address - Phone:770-865-1509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-1165251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health