Provider Demographics
NPI:1619191822
Name:HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-303-5500
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-0200
Mailing Address - Country:US
Mailing Address - Phone:706-303-5500
Mailing Address - Fax:706-854-7382
Practice Address - Street 1:2421 E SOUTHERN AVE STE 1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7612
Practice Address - Country:US
Practice Address - Phone:480-413-9087
Practice Address - Fax:480-413-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA1412251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZHHA1412OtherSTATE HHA LICENSE #
AZHHA1412OtherSTATE HHA LICENSE #