Provider Demographics
NPI:1013895010
Name:WILLOWGROVE HOMECARE
Entity type:Organization
Organization Name:WILLOWGROVE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-383-6376
Mailing Address - Street 1:105 JW PLAZA DR SE STE 10
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-1503
Mailing Address - Country:US
Mailing Address - Phone:706-383-6376
Mailing Address - Fax:
Practice Address - Street 1:105 JW PLAZA DR SE STE 10
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-1503
Practice Address - Country:US
Practice Address - Phone:706-383-6376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health