Healthcare Provider Details

I. General information

NPI: 1164190625
Provider Name (Legal Business Name): RIGHTEOUS HANDS PERSONAL CARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 MAPLE GROVE WAY
MARIETTA GA
30066-5824
US

IV. Provider business mailing address

673 MAPLE GROVE WAY
MARIETTA GA
30066-5824
US

V. Phone/Fax

Practice location:
  • Phone: 404-585-2973
  • Fax: 404-855-2647
Mailing address:
  • Phone: 404-585-2973
  • Fax: 404-855-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DIANTHA BYRD
Title or Position: ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 404-585-2973