Provider Demographics
NPI:1629776257
Name:UNI-V HOMECARE, LLC.
Entity Type:Organization
Organization Name:UNI-V HOMECARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SON
Authorized Official - Middle Name:BANG
Authorized Official - Last Name:MAI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:404-543-6941
Mailing Address - Street 1:5977 FOXCROFT CT
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1058
Mailing Address - Country:US
Mailing Address - Phone:404-543-6941
Mailing Address - Fax:
Practice Address - Street 1:5977 FOXCROFT CT
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1058
Practice Address - Country:US
Practice Address - Phone:404-543-6941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHCP010463OtherGEORGIA DEPARTMENT COMMUNITY HEALTH