NPIMap

Organization Active NPI

Providia Home Care LLC

  • In Home Supportive Care Agency
  • Loganville, GA
National Provider Identifier
1598150526
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
075-R-0965 Issued in GA
Legal business name
PROVIDIA HOME CARE LLC
Practice address
915 Yancey CT
Suite 105
Loganville, GA 30052-9037
Phone
(404) 406-2514
NPI assigned
Apr 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Authorized official

Name
Miss Tova Nieves
Title
Admnistrator
Phone
(404) 406-2514

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 075-R-0965 GA
In Home Supportive Care Agency 253Z00000X 075-R-0965 GA Primary

Addresses

Primary practice location

915 Yancey CT
Suite 105
Loganville, GA 30052-9037

Mailing address

915 Yancey CT
Suite 105
Loganville, GA 30052-9037
Phone (404) 406-2514

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1598150526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 YANCEY CT",
            "address_2": "SUITE 105",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300529037",
            "telephone_number": "404-406-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 YANCEY CT",
            "address_2": "SUITE 105",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300529037",
            "telephone_number": "404-406-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDIA HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "NIEVES",
        "authorized_official_first_name": "TOVA",
        "authorized_official_title_or_position": "ADMNISTRATOR",
        "authorized_official_telephone_number": "404-406-2514",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "075-R-0965",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "075-R-0965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.