Provider Demographics
NPI:1114213212
Name:WHITSYMS IN-HOME CARE
Entity Type:Organization
Organization Name:WHITSYMS IN-HOME CARE
Other - Org Name:WHITSYMS IN-HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-209-2282
Mailing Address - Street 1:11175 CICERO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1179
Mailing Address - Country:US
Mailing Address - Phone:678-209-2282
Mailing Address - Fax:678-317-0953
Practice Address - Street 1:7866 W COMMERICAL BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-358-2049
Practice Address - Fax:954-358-2231
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN IN-HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNR30211390OtherAHCA NURSE REGISTRY LICENSE