Provider Demographics
NPI:1194464008
Name:DANTILY HOMECARE LLC
Entity Type:Organization
Organization Name:DANTILY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIMINI
Authorized Official - Middle Name:MILDRED
Authorized Official - Last Name:ASGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-571-1548
Mailing Address - Street 1:4045 HERITAGE CROSSING PT SW
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-9179
Mailing Address - Country:US
Mailing Address - Phone:678-571-1548
Mailing Address - Fax:
Practice Address - Street 1:4045 HERITAGE CROSSING PT SW
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-9179
Practice Address - Country:US
Practice Address - Phone:678-571-1548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health