# 1111 HOME CARE, LLC

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

## Provider details

- **NPI number:** 1568228963
- **Authorized official:** MR. JAMES EDWARD JONES JR. (OWNER)
- **Authorized official phone:** (678) 492-8661

## Contact information

- **Practice address:** 118 WOODWAY PARK DR, SANDY SPRINGS, GA 30350-4543
- **Practice address phone:** (678) 492-8661
- **Mailing address:** 118 WOODWAY PARK DR, SANDY SPRINGS, GA 30350-4543
- **Mailing address phone:** (678) 492-8661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2024
- **Last updated:** 02/23/2024