Provider Demographics
NPI:1609487487
Name:LIVING PRIVATE HOME CARE, LLC
Entity Type:Organization
Organization Name:LIVING PRIVATE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STRIPLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-604-8266
Mailing Address - Street 1:101 DEVANT ST STE 105A
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-2711
Mailing Address - Country:US
Mailing Address - Phone:404-604-8266
Mailing Address - Fax:678-519-1407
Practice Address - Street 1:101 DEVANT ST STE 105A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-2711
Practice Address - Country:US
Practice Address - Phone:404-604-8266
Practice Address - Fax:678-519-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care