Provider Demographics
NPI:1407044084
Name:HOME SWEET HOME CARE
Entity type:Organization
Organization Name:HOME SWEET HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:DEMETRIUS
Authorized Official - Last Name:STRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-881-2258
Mailing Address - Street 1:3970 RODNOR FOREST LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-4414
Mailing Address - Country:US
Mailing Address - Phone:229-430-8083
Mailing Address - Fax:229-430-8237
Practice Address - Street 1:3970 RODNOR FOREST LN
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31721-4414
Practice Address - Country:US
Practice Address - Phone:229-430-8083
Practice Address - Fax:229-430-8237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047-R-0365251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health