# BRIDGE 2 PEACE HOME CARE LLC

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

## Provider details

- **NPI number:** 1043049414
- **Authorized official:** MS. LAVONNE DAVIS (HEAD ADMIN/OWNER)
- **Authorized official phone:** (404) 429-6630

## Contact information

- **Practice address:** 83 CORTESE LN, BRASELTON, GA 30517-2916
- **Practice address phone:** (404) 429-6630
- **Mailing address:** 83 CORTESE LN, BRASELTON, GA 30517-2916
- **Mailing address phone:** (404) 429-6630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2024
- **Last updated:** 08/01/2024