Provider Demographics
NPI:1588969828
Name:JUST L HOME LLC
Entity type:Organization
Organization Name:JUST L HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - SOLE MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-523-7887
Mailing Address - Street 1:1108 MITFORD LN
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7428
Mailing Address - Country:US
Mailing Address - Phone:770-682-3439
Mailing Address - Fax:770-682-3439
Practice Address - Street 1:1108 MITFORD LN
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7428
Practice Address - Country:US
Practice Address - Phone:770-682-3439
Practice Address - Fax:770-682-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R0764251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health