Healthcare Provider Details

I. General information

NPI: 1275468308
Provider Name (Legal Business Name): AMITY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 TROPHY CLUB AVE
DACULA GA
30019-7590
US

IV. Provider business mailing address

1226 TROPHY CLUB AVE
DACULA GA
30019-7590
US

V. Phone/Fax

Practice location:
  • Phone: 404-477-8775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAHIDA DULAY
Title or Position: OWNER
Credential:
Phone: 404-477-8775