NPIMap

Organization Active NPI

Solidarity Home Care LLC

  • Home Health Agency
  • Douglasville, GA
National Provider Identifier
1295359388
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SOLIDARITY HOME CARE LLC
Practice address
4670 Bald Eagle Way
Douglasville, GA 30135-7489
Phone
(470) 707-3979
Fax
(678) 503-2021
NPI assigned
Jun 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Phaedra R BrownNPI 1821612912
Title
Owner/Manager
Phone
(470) 707-3979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X
Respite Care 385H00000X

Addresses

Primary practice location

4670 Bald Eagle Way
Douglasville, GA 30135-7489

Mailing address

4670 Bald Eagle Way
Douglasville, GA 30135-7489
Phone (470) 707-3979

Other identifiers 2

IdentifierTypeStateIssuer
003247233AMedicaidGA
1295359388MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL solidarityhc@gmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1295359388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 BALD EAGLE WAY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357489",
            "telephone_number": "470-707-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 BALD EAGLE WAY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357489",
            "telephone_number": "470-707-3979",
            "fax_number": "678-503-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLIDARITY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "PHAEDRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "470-707-3979"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003247233A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295359388",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "solidarityhc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "solidarityhc@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4670 Bald Eagle Way",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301357489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.