Healthcare Provider Details

I. General information

NPI: 1073203824
Provider Name (Legal Business Name): AYO HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 05/15/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 VILLA GRANDE DR
LOCUST GROVE GA
30248-7110
US

IV. Provider business mailing address

PO BOX 567
LOCUST GROVE GA
30248-0567
US

V. Phone/Fax

Practice location:
  • Phone: 678-284-2833
  • Fax:
Mailing address:
  • Phone: 678-284-2833
  • 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: MS. VALERIE DRISKELL BROWN
Title or Position: COORDINATOR
Credential:
Phone: 678-284-2833