Provider Demographics
NPI:1982270955
Name:VIET HOME CARE LLC
Entity Type:Organization
Organization Name:VIET HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OANH
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-447-7554
Mailing Address - Street 1:5961 LIVE OAK PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1737
Mailing Address - Country:US
Mailing Address - Phone:770-447-7554
Mailing Address - Fax:
Practice Address - Street 1:5961 LIVE OAK PKWY STE B
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1737
Practice Address - Country:US
Practice Address - Phone:770-447-7554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003229120AMedicaid