Provider Demographics
NPI:1720878986
Name:COMMITTED ANGELS HOME CARE LLC
Entity type:Organization
Organization Name:COMMITTED ANGELS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:DOROTHY
Authorized Official - Last Name:REID PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-397-3674
Mailing Address - Street 1:2635 HIGH ST SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6848
Mailing Address - Country:US
Mailing Address - Phone:470-257-8515
Mailing Address - Fax:
Practice Address - Street 1:3750 PEACHTREE RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-1385
Practice Address - Country:US
Practice Address - Phone:367-379-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care