Provider Demographics
NPI:1538917257
Name:AMITY ONE CARE LLC
Entity type:Organization
Organization Name:AMITY ONE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAJELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-254-1640
Mailing Address - Street 1:4310 PENRITH DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2000
Mailing Address - Country:US
Mailing Address - Phone:678-254-1640
Mailing Address - Fax:
Practice Address - Street 1:4310 PENRITH DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-2000
Practice Address - Country:US
Practice Address - Phone:678-254-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care