Healthcare Provider Details

I. General information

NPI: 1235959594
Provider Name (Legal Business Name): CHIZIK ENTERPRISES INTERNATIONAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 GREENWAY DR
AUGUSTA GA
30909-4321
US

IV. Provider business mailing address

1609 GREENWAY DR
AUGUSTA GA
30909-4321
US

V. Phone/Fax

Practice location:
  • Phone: 404-937-9669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: ISAAC CHIKODI OGBUAGU
Title or Position: CEO
Credential:
Phone: 404-937-9669