Provider Demographics
NPI:1336702208
Name:HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOUTHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:067-854-7428
Mailing Address - Street 1:933 BROAD ST STE 301
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-7222
Mailing Address - Country:US
Mailing Address - Phone:706-854-7428
Mailing Address - Fax:
Practice Address - Street 1:629 RONALD REAGAN DR STE 3C
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-7608
Practice Address - Country:US
Practice Address - Phone:706-854-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care