# FAMILY PROVIDENCE HOME CARE LLC

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

## Provider details

- **NPI number:** 1922883156
- **Authorized official:** TIYA HILL (OWNER)
- **Authorized official phone:** (770) 250-1758

## Contact information

- **Practice address:** 2744 POWELL CT, MONROE, GA 30656-8675
- **Practice address phone:** (770) 250-1758
- **Mailing address:** 146 MLK JR BLVD \# 253, MONROE, GA 30655-5620
- **Mailing address phone:** (770) 250-1758

## Taxonomy

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

## Other

- **Enumeration date:** 08/28/2023
- **Last updated:** 08/28/2023