Provider Demographics
NPI:1063883031
Name:TRUE LIFE HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:TRUE LIFE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-433-3781
Mailing Address - Street 1:360 W BENSON ST
Mailing Address - Street 2:7
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4330
Mailing Address - Country:US
Mailing Address - Phone:404-433-3781
Mailing Address - Fax:
Practice Address - Street 1:360 W BENSON ST
Practice Address - Street 2:7
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4330
Practice Address - Country:US
Practice Address - Phone:404-433-3781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044R1411251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health