Organization
PROUD LIFE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY M REESE (OWNER)
(281) 818-9606
Entity
Organization
Contact information
Practice address
10053 TARA GLYNN DR, HAMPTON, GA 30228-6131
(678) 883-1407
Mailing address
1700 NORTHSIDE DR NW STE A7, ATLANTA, GA 30318-2695
(478) 226-5568
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
06/19/2023
Last updated
02/04/2025
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