Provider Demographics
NPI:1013782523
Name:ST.JOE'S HOMECARE LLC
Entity Type:Organization
Organization Name:ST.JOE'S HOMECARE LLC
Other - Org Name:ST.JOE'S HOMECARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KOJO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-980-2313
Mailing Address - Street 1:1161 W MILL DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-5416
Mailing Address - Country:US
Mailing Address - Phone:404-980-2313
Mailing Address - Fax:
Practice Address - Street 1:1161 W MILL DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-5416
Practice Address - Country:US
Practice Address - Phone:404-980-2313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST.JOE'S HOMECARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-15
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care