Provider Demographics
NPI:1083430565
Name:SWEET HOME PRIVATE CARE LLC
Entity type:Organization
Organization Name:SWEET HOME PRIVATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMANDI
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:404-348-3658
Mailing Address - Street 1:15845 NE 51ST ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5242
Mailing Address - Country:US
Mailing Address - Phone:404-348-3658
Mailing Address - Fax:
Practice Address - Street 1:15845 NE 51ST ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5242
Practice Address - Country:US
Practice Address - Phone:404-348-3658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care