Healthcare Provider Details

I. General information

NPI: 1619514924
Provider Name (Legal Business Name): OPESDEI HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 ABBOTTS BRIDGE ROAD 6615 ABBOTTS BRIDGE ROAD UNIT 1111
JOHNS CREEK GA
30097
US

IV. Provider business mailing address

6615 ABBOTTS BRIDGE ROAD 6615 ABBOTTS BRIDGE ROAD UNIT 1111
JOHNS CREEK GA
30097
US

V. Phone/Fax

Practice location:
  • Phone: 901-864-5828
  • Fax:
Mailing address:
  • Phone: 901-864-5828
  • 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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MISS ERIKA JENEEN PEARSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 901-864-5828