Provider Demographics
NPI:1770300691
Name:LOOMS HOME CARE SERVICES
Entity type:Organization
Organization Name:LOOMS HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KOLAWOLE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ALALADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-312-8536
Mailing Address - Street 1:3144 WISTERIA WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30344-5328
Mailing Address - Country:US
Mailing Address - Phone:404-312-8536
Mailing Address - Fax:
Practice Address - Street 1:3144 WISTERIA WAY
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30344-5328
Practice Address - Country:US
Practice Address - Phone:404-312-8536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health