Provider Demographics
NPI:1972268233
Name:PLEASANT HOME CARE LLC
Entity type:Organization
Organization Name:PLEASANT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KANETRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-356-6376
Mailing Address - Street 1:5066 PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3040
Mailing Address - Country:US
Mailing Address - Phone:678-356-6376
Mailing Address - Fax:
Practice Address - Street 1:5066 PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3040
Practice Address - Country:US
Practice Address - Phone:678-356-6376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health