Provider Demographics
NPI:1326517780
Name:METRO 1 HOME CARE INC
Entity Type:Organization
Organization Name:METRO 1 HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHIOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MBONU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-689-3003
Mailing Address - Street 1:3613 BRASELTON HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-4665
Mailing Address - Country:US
Mailing Address - Phone:678-689-3003
Mailing Address - Fax:
Practice Address - Street 1:3613 BRASELTON HWY STE 103
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-4665
Practice Address - Country:US
Practice Address - Phone:678-689-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003113770AMedicaid