Proud Life Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROUD LIFE HOME CARE LLC

Practice address

10053 Tara Glynn Dr
Hampton, GA 30228-6131

Phone

(678) 883-1407

NPI assigned

Jun 19, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tony M Reese

Title

Owner

Phone

(281) 818-9606

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1033894068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NORTHSIDE DR NW STE A7",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182695",
            "telephone_number": "478-226-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10053 TARA GLYNN DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302286131",
            "telephone_number": "678-883-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROUD LIFE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-818-9606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.