Healthcare Provider Details

I. General information

NPI: 1093513046
Provider Name (Legal Business Name): RICEWAY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL STE 7446
ATLANTA GA
30350-2995
US

IV. Provider business mailing address

8735 DUNWOODY PL STE 7446
ATLANTA GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 404-462-0655
  • Fax: 404-462-0655
Mailing address:
  • Phone: 404-462-0655
  • Fax: 404-462-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SHAWNTRICE TAYLOR-TRAVIS
Title or Position: MANAGING MEMBER
Credential:
Phone: 404-462-0655