Provider Demographics
NPI:1821681362
Name:PRIDE HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:PRIDE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:067-946-6070
Mailing Address - Street 1:PO BOX 2713
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-0048
Mailing Address - Country:US
Mailing Address - Phone:706-946-6070
Mailing Address - Fax:844-299-1016
Practice Address - Street 1:11 OVERVIEW DR STE 31
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6687
Practice Address - Country:US
Practice Address - Phone:706-946-6070
Practice Address - Fax:844-299-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care