Provider Demographics
NPI:1356187603
Name:GEM HOME CARE LLC
Entity type:Organization
Organization Name:GEM HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED NURSE
Authorized Official - Phone:770-212-1214
Mailing Address - Street 1:1313 ASBURY SQ
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2412
Mailing Address - Country:US
Mailing Address - Phone:770-212-1214
Mailing Address - Fax:
Practice Address - Street 1:1313 ASBURY SQ
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30346-2412
Practice Address - Country:US
Practice Address - Phone:770-212-1214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health