Provider Demographics
NPI:1275686586
Name:HOMENURSE INC.
Entity Type:Organization
Organization Name:HOMENURSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-229-9153
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:SUNNY SIDE
Mailing Address - State:GA
Mailing Address - Zip Code:30284-0634
Mailing Address - Country:US
Mailing Address - Phone:770-229-9153
Mailing Address - Fax:678-884-1476
Practice Address - Street 1:2920 N EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-6495
Practice Address - Country:US
Practice Address - Phone:770-229-9153
Practice Address - Fax:678-884-1476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA126-R-0001251E00000X, 251G00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251G00000XAgenciesHospice Care, Community Based
Not Answered251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00353438DMedicaid
GA00353438CMedicaid