Provider Demographics
NPI:1073864120
Name:BENNETT'S LOVING TOUCH HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BENNETT'S LOVING TOUCH HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEMETRIC
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-347-7366
Mailing Address - Street 1:163 SOUTHGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8036
Mailing Address - Country:US
Mailing Address - Phone:770-347-7366
Mailing Address - Fax:229-394-4898
Practice Address - Street 1:163 SOUTHGATE BLVD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8036
Practice Address - Country:US
Practice Address - Phone:770-347-7366
Practice Address - Fax:229-394-4898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA075-R-1086251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health