Provider Demographics
NPI:1427446467
Name:AMERICAN IN-HOME CARE
Entity type:Organization
Organization Name:AMERICAN IN-HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-209-2282
Mailing Address - Street 1:11175 CICERO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1179
Mailing Address - Country:US
Mailing Address - Phone:678-209-2282
Mailing Address - Fax:678-317-0953
Practice Address - Street 1:9471 BAYMEADOWS RD
Practice Address - Street 2:SUITE 401
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7932
Practice Address - Country:US
Practice Address - Phone:904-737-7667
Practice Address - Fax:904-220-1930
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN IN-HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-29
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNR30211295OtherAHCA NURSE REGISTRY LICENSE