Healthcare Provider Details

I. General information

NPI: 1689412744
Provider Name (Legal Business Name): CATUN COVE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 N DECATUR RD STE 107
DECATUR GA
30032-1000
US

IV. Provider business mailing address

3561 SANDY WOODS LN
STONE MOUNTAIN GA
30083-4048
US

V. Phone/Fax

Practice location:
  • Phone: 678-794-3577
  • Fax:
Mailing address:
  • Phone: 404-369-6582
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State

VIII. Authorized Official

Name: SAMIA KATUN
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 404-369-6582