Provider Demographics
NPI:1568009447
Name:ONE-TO-ONE HOME CARE LLC
Entity Type:Organization
Organization Name:ONE-TO-ONE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:FORNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-694-1777
Mailing Address - Street 1:2470 WINDY HILL RD SE STE 268
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8620
Mailing Address - Country:US
Mailing Address - Phone:770-694-1777
Mailing Address - Fax:678-503-2292
Practice Address - Street 1:2470 WINDY HILL RD SE STE 268
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8620
Practice Address - Country:US
Practice Address - Phone:770-694-1777
Practice Address - Fax:678-503-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1932677812Medicaid