Provider Demographics
NPI:1750838439
Name:VENTURES LLC
Entity Type:Organization
Organization Name:VENTURES LLC
Other - Org Name:ALIVE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:OTHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-496-9147
Mailing Address - Street 1:235 W ROOSEVELT AVE STE 248
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2395
Mailing Address - Country:US
Mailing Address - Phone:229-496-9147
Mailing Address - Fax:229-496-9258
Practice Address - Street 1:235 W ROOSEVELT AVE STE 248
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2395
Practice Address - Country:US
Practice Address - Phone:229-496-9147
Practice Address - Fax:229-496-9258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047-R-1626251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health