Radiance Home Care Services, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

RADIANCE HOME CARE SERVICES, LLC

Practice address

4914 West St
Forest Park, GA 30297-2226

Phone

(404) 761-6501

NPI assigned

Sep 23, 2021

Organization subpart

No

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

Authorized official

Name

Marilyn Lewis

Title

Officer

Phone

(404) 992-2958

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1619648102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 WEST ST",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972226",
            "telephone_number": "404-761-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 WEST ST",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972226",
            "telephone_number": "404-761-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "404-992-2958"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Laptop",
            "address_1": "4914 West St",
            "city": "Forest Park",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302972226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.