Provider Demographics
NPI:1316792963
Name:ENVISION HOME CARE, LLC
Entity type:Organization
Organization Name:ENVISION HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-493-3566
Mailing Address - Street 1:212 SIDNEY DAVID ST
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2987
Mailing Address - Country:US
Mailing Address - Phone:404-493-3566
Mailing Address - Fax:
Practice Address - Street 1:212 SIDNEY DAVID ST
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2987
Practice Address - Country:US
Practice Address - Phone:404-493-3566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child