Provider Demographics
NPI:1083157226
Name:UNITED HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:UNITED HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARKCHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-846-5602
Mailing Address - Street 1:1122 GRAY HWY
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-1869
Mailing Address - Country:US
Mailing Address - Phone:478-305-7338
Mailing Address - Fax:478-345-3005
Practice Address - Street 1:1122 GRAY HWY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-1869
Practice Address - Country:US
Practice Address - Phone:478-305-7338
Practice Address - Fax:478-345-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011-R-1360251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care