Organization
LA PROVIDENCE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLIE BRUTUS (OWNER/PRESIDENT)
(770) 337-0453
Entity
Organization
Contact information
Practice address
2727 FLINTLOCK PL, AUSTELL, GA 30106-2707
(770) 337-0453
Mailing address
2727 FLINTLOCK PL, AUSTELL, GA 30106-2707
(770) 337-0453
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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