# PROUD LIFE HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033894068
- **Authorized official:** MR. TONY M REESE (OWNER)
- **Authorized official phone:** (281) 818-9606

## Contact information

- **Practice address:** 10053 TARA GLYNN DR, HAMPTON, GA 30228-6131
- **Practice address phone:** (678) 883-1407
- **Mailing address:** 1700 NORTHSIDE DR NW STE A7, ATLANTA, GA 30318-2695
- **Mailing address phone:** (478) 226-5568

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |

## Other

- **Enumeration date:** 06/19/2023
- **Last updated:** 02/04/2025