Provider Demographics
NPI:1467299420
Name:PRIVE HOME CARE NETWORK LLC
Entity type:Organization
Organization Name:PRIVE HOME CARE NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-593-5967
Mailing Address - Street 1:2045 MOUNT ZION RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3313
Mailing Address - Country:US
Mailing Address - Phone:678-593-5967
Mailing Address - Fax:
Practice Address - Street 1:6864 HIDDENLAKE DR
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-2163
Practice Address - Country:US
Practice Address - Phone:678-593-5967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No251S00000XAgenciesCommunity/Behavioral Health