# LA PROVIDENCE HOME CARE, LLC

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

## Provider details

- **NPI number:** 1295215390
- **Authorized official:** MARLIE BRUTUS (OWNER/PRESIDENT)
- **Authorized official phone:** (770) 337-0453

## Contact information

- **Practice address:** 2727 FLINTLOCK PL, AUSTELL, GA 30106-2707
- **Practice address phone:** (770) 337-0453
- **Mailing address:** 2727 FLINTLOCK PL, AUSTELL, GA 30106-2707
- **Mailing address phone:** (770) 337-0453

## Taxonomy

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

## Other

- **Enumeration date:** 08/17/2018
- **Last updated:** 08/17/2018