Provider Demographics
NPI:1497478382
Name:PREVAL HOME CARE
Entity Type:Organization
Organization Name:PREVAL HOME CARE
Other - Org Name:PREVAL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WEASLYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:347-589-9508
Mailing Address - Street 1:1445 WOODMONT LN NW # 722
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2866
Mailing Address - Country:US
Mailing Address - Phone:470-322-5331
Mailing Address - Fax:
Practice Address - Street 1:1445 WOODMONT LN NW # 722
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2866
Practice Address - Country:US
Practice Address - Phone:470-322-5331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care