Provider Demographics
NPI:1679283329
Name:GODFIDENT LOVE HOMECARE LLC
Entity type:Organization
Organization Name:GODFIDENT LOVE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-707-3691
Mailing Address - Street 1:1495 DULUTH HWY STE F1021
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5143
Mailing Address - Country:US
Mailing Address - Phone:800-447-9503
Mailing Address - Fax:855-246-7452
Practice Address - Street 1:1564 HERRINGTON RD APT 2321
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-7950
Practice Address - Country:US
Practice Address - Phone:678-707-3691
Practice Address - Fax:855-246-7452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251J00000XAgenciesNursing Care