Healthcare Provider Details

I. General information

NPI: 1427962596
Provider Name (Legal Business Name): AHAVA HOSPICE & HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PARKWOOD CIR SE STE 500
ATLANTA GA
30339-2147
US

IV. Provider business mailing address

1600 PARKWOOD CIR SE STE 500
ATLANTA GA
30339-2147
US

V. Phone/Fax

Practice location:
  • Phone: 678-996-5030
  • Fax:
Mailing address:
  • Phone: 678-996-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. BONITA C YESHURUN
Title or Position: OWNER/ADMINISTRATOR
Credential: RN
Phone: 678-996-5030