Provider Demographics
NPI:1629624150
Name:CARE AT HOME HOME CARE, LLC
Entity Type:Organization
Organization Name:CARE AT HOME HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:GARDENHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-3482
Mailing Address - Street 1:114 ENTERPRISE CT STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3115
Mailing Address - Country:US
Mailing Address - Phone:706-507-3482
Mailing Address - Fax:706-507-3488
Practice Address - Street 1:114 ENTERPRISE CT STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3115
Practice Address - Country:US
Practice Address - Phone:706-507-3482
Practice Address - Fax:706-507-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health