Provider Demographics
NPI:1962708255
Name:SIMPLY YOURS HOME CARE
Entity type:Organization
Organization Name:SIMPLY YOURS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BOMECKA
Authorized Official - Middle Name:LA SHAWN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-368-4696
Mailing Address - Street 1:1408 SUGARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-2520
Mailing Address - Country:US
Mailing Address - Phone:678-368-4696
Mailing Address - Fax:678-368-4696
Practice Address - Street 1:1408 SUGARWOOD LN
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2520
Practice Address - Country:US
Practice Address - Phone:678-368-4696
Practice Address - Fax:678-368-4696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health