Healthcare Provider Details

I. General information

NPI: 1376378471
Provider Name (Legal Business Name): KITTY'S HOME KARE SERVIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5365 OLD BILL COOK RD
ATLANTA GA
30349-3145
US

IV. Provider business mailing address

5365 OLD BILL COOK RD
ATLANTA GA
30349-3145
US

V. Phone/Fax

Practice location:
  • Phone: 470-716-8370
  • Fax:
Mailing address:
  • Phone: 470-716-8370
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. METLISSA YONLANDA PATTEN
Title or Position: DIRECTOR
Credential:
Phone: 470-716-8370