Provider Demographics
NPI:1831755198
Name:MOLLINS, VENTRISHA LINETT
Entity type:Individual
Prefix:
First Name:VENTRISHA
Middle Name:LINETT
Last Name:MOLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PARADISE OF
Other - Middle Name:JOY
Other - Last Name:HOMECARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PARADISE OF JOY HOME
Mailing Address - Street 1:1212 HWY 84 W
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-1519
Mailing Address - Country:US
Mailing Address - Phone:229-397-0380
Mailing Address - Fax:229-397-0381
Practice Address - Street 1:1212 HWY 84 W
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-1519
Practice Address - Country:US
Practice Address - Phone:122-397-0380
Practice Address - Fax:229-397-0381
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA843289394OtherPARADISE OF JOY HOMECARE LLC