Provider Demographics
NPI:1740814805
Name:EMERITUS HOME CARE LLC
Entity type:Organization
Organization Name:EMERITUS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EARLINDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHAW-AKANNI
Authorized Official - Suffix:
Authorized Official - Credentials:MIB/MBA
Authorized Official - Phone:404-426-3955
Mailing Address - Street 1:5885 CUMMING HWY STE 108-210
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5765
Mailing Address - Country:US
Mailing Address - Phone:678-250-6889
Mailing Address - Fax:
Practice Address - Street 1:384 FRIARS HEAD DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7643
Practice Address - Country:US
Practice Address - Phone:678-250-6889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care