MEDICARE: HOLIGENIX HEALTHCARE 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	:	1881524270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLIGENIX HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4014 OPHIE DR NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-2330
Country	:	US
Telephone Number	:	888-857-8667
Fax Number	:

Provider Business Practice Location Address
First Line	:	4014 OPHIE DR NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-2330
Country	:	US
Telephone Number	:	888-857-8667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YINESSA NICOLE DAVIS-CACAPIT
Credential	:	RN
Telephone Number	:	601-480-4002

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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