MEDICARE: ATL HOME CARE AGENCY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1326997750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATL HOME CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	2073 ARBOR SPRINGS WAY
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30519-2287
Country	:	US
Telephone Number	:	943-288-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2073 ARBOR SPRINGS WAY
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30519-2287
Country	:	US
Telephone Number	:	943-288-3800
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NICKEYA A JORDAN
Credential	:
Telephone Number	:	943-288-3800

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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