# PEACH STATE HOME CARE SERVICE LLC

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

## Provider details

- **NPI number:** 1396522025
- **Authorized official:** VU HOANG (OWNER)
- **Authorized official phone:** (678) 814-7966

## Contact information

- **Practice address:** 1560 CHADWICK DR, LAWRENCEVILLE, GA 30043-7092
- **Practice address phone:** (678) 814-7966
- **Mailing address:** 1560 CHADWICK DR, LAWRENCEVILLE, GA 30043-7092

## Taxonomy

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

## Other

- **Enumeration date:** 09/14/2023
- **Last updated:** 09/14/2023