Provider Demographics
NPI:1467231183
Name:PASSIONATE CARE GIVERS HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:PASSIONATE CARE GIVERS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:SCHOLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:IBEZIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-908-8870
Mailing Address - Street 1:319 HARDIN HOME WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6045
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2272 AZALEA DR STE A-2
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-2653
Practice Address - Country:US
Practice Address - Phone:678-908-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health