Healthcare Provider Details

I. General information

NPI: 1629924196
Provider Name (Legal Business Name): ASCENSION HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 BURNS VIEW LN
LAWRENCEVILLE GA
30044-7705
US

IV. Provider business mailing address

2145 BURNS VIEW LN
LAWRENCEVILLE GA
30044-7705
US

V. Phone/Fax

Practice location:
  • Phone: 762-578-5913
  • Fax: 762-578-5913
Mailing address:
  • Phone: 762-578-5913
  • Fax: 762-578-5913

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: ELUEMUNOR N OCHONOGOR
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 762-578-5913