Healthcare Provider Details

I. General information

NPI: 1538096433
Provider Name (Legal Business Name): MOBILE PRIDE PROPERTIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4625 KENT RD
ATLANTA GA
30337-5315
US

IV. Provider business mailing address

4625 KENT RD
ATLANTA GA
30337-5315
US

V. Phone/Fax

Practice location:
  • Phone: 678-613-7786
  • Fax:
Mailing address:
  • Phone: 678-613-7786
  • 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: MICHAEL A MYERS
Title or Position: OWNER
Credential:
Phone: 678-613-7786