Healthcare Provider Details

I. General information

NPI: 1386574911
Provider Name (Legal Business Name): RIVERS OF LIVING WATERS HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 JULIE CT
FORTSON GA
31808-5348
US

IV. Provider business mailing address

1639 BRADLEY PARK DR STE 500
COLUMBUS GA
31904-3623
US

V. Phone/Fax

Practice location:
  • Phone: 706-593-0729
  • Fax:
Mailing address:
  • Phone: 706-593-0729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number
License Number StateNULL

VIII. Authorized Official

Name: LISA HINTON
Title or Position: CEO
Credential:
Phone: 706-593-0729