Provider Demographics
NPI:1841596905
Name:WARREN CARE SERVICES, LLC
Entity Type:Organization
Organization Name:WARREN CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:LAMONTE
Authorized Official - Last Name:LEATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-522-6413
Mailing Address - Street 1:3974 ANNISTOWN RD
Mailing Address - Street 2:STE 714
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8476
Mailing Address - Country:US
Mailing Address - Phone:678-522-6413
Mailing Address - Fax:
Practice Address - Street 1:1237 WESTMORELAND DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-1465
Practice Address - Country:US
Practice Address - Phone:336-270-5259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-001-138311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home