Healthcare Provider Details

I. General information

NPI: 1689549370
Provider Name (Legal Business Name): FAVORED HOMECARE AGENCY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3966 KINGSBROOK BLVD
DECATUR GA
30034-5747
US

IV. Provider business mailing address

3966 KINGSBROOK BLVD
DECATUR GA
30034-5747
US

V. Phone/Fax

Practice location:
  • Phone: 848-467-1259
  • Fax: 848-467-1259
Mailing address:
  • Phone: 848-467-1259
  • Fax: 848-467-1259

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. AISHATU HYPPOLITE
Title or Position: OWNER
Credential: RN
Phone: 848-467-1259