Provider Demographics
NPI:1760250989
Name:SLYCHOK HOME CARE LLC
Entity Type:Organization
Organization Name:SLYCHOK HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ETHEL
Authorized Official - Middle Name:UZO
Authorized Official - Last Name:NWADIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-444-9602
Mailing Address - Street 1:6689 LAKEFIELD FORREST DR
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-1975
Mailing Address - Country:US
Mailing Address - Phone:404-444-9602
Mailing Address - Fax:
Practice Address - Street 1:6689 LAKEFIELD FORREST DR
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-1975
Practice Address - Country:US
Practice Address - Phone:404-444-9602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty