Provider Demographics
NPI:1386479467
Name:EQUITABLE HOME CARE SOLUTIONS LLC
Entity type:Organization
Organization Name:EQUITABLE HOME CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-604-5635
Mailing Address - Street 1:260 LEGENDS TRCE
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8817
Mailing Address - Country:US
Mailing Address - Phone:706-604-5635
Mailing Address - Fax:
Practice Address - Street 1:233 12TH ST STE 500C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2462
Practice Address - Country:US
Practice Address - Phone:706-604-5635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care