Healthcare Provider Details

I. General information

NPI: 1992153134
Provider Name (Legal Business Name): AMERICAN HEARTS & HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 ENTERPRISE PATH STE 101
HIRAM GA
30141-2655
US

IV. Provider business mailing address

125 TOWNPARK DR SUITE 300
KENNESAW GA
30144-2411
US

V. Phone/Fax

Practice location:
  • Phone: 470-305-1490
  • Fax: 470-357-6362
Mailing address:
  • Phone: 404-474-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care 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: CAPRISHA WARREN
Title or Position: OWNER
Credential:
Phone: 470-422-8769