Provider Demographics
NPI:1407318389
Name:1ST SENIOR HOMECARE, LLC
Entity Type:Organization
Organization Name:1ST SENIOR HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VAN
Authorized Official - Middle Name:THUY THI
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-289-2222
Mailing Address - Street 1:7116 PEACHTREE INDUSTRIAL BLVD.
Mailing Address - Street 2:BLDG 4 SUITE A
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071
Mailing Address - Country:US
Mailing Address - Phone:678-829-2929
Mailing Address - Fax:678-601-2918
Practice Address - Street 1:7116 PEACHTREE INDUSTRIAL BLVD.
Practice Address - Street 2:BLDG 4 SUITE A
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071
Practice Address - Country:US
Practice Address - Phone:678-829-2929
Practice Address - Fax:678-601-2918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health