Provider Demographics
NPI:1215384086
Name:DEDICATED HOME CARE, INC
Entity Type:Organization
Organization Name:DEDICATED HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUOBADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-860-8865
Mailing Address - Street 1:50 HURT PLZ SE
Mailing Address - Street 2:SUITE 1528
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 HURT PLZ SE
Practice Address - Street 2:SUITE 1528
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2946
Practice Address - Country:US
Practice Address - Phone:404-934-5274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health