Provider Demographics
NPI:1558880781
Name:US HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:US HOME CARE AGENCY, INC.
Other - Org Name:US HOME CARE AGENCY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:CHIBUZOR
Authorized Official - Last Name:OKERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-986-2500
Mailing Address - Street 1:PO BOX 1451
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-0025
Mailing Address - Country:US
Mailing Address - Phone:678-986-2500
Mailing Address - Fax:679-926-3032
Practice Address - Street 1:3102 TRINITY GROVE DR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1044
Practice Address - Country:US
Practice Address - Phone:678-986-2500
Practice Address - Fax:678-926-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-1615253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care