Provider Demographics
NPI:1952695751
Name:DEVOTION HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:DEVOTION HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:IFEANYI
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-817-4418
Mailing Address - Street 1:101 KENWOOD RD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-3418
Mailing Address - Country:US
Mailing Address - Phone:678-817-4418
Mailing Address - Fax:678-817-4419
Practice Address - Street 1:101 KENWOOD RD
Practice Address - Street 2:SUITE 26
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-3418
Practice Address - Country:US
Practice Address - Phone:678-817-4418
Practice Address - Fax:678-817-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056R0777251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health