Healthcare Provider Details

I. General information

NPI: 1881524270
Provider Name (Legal Business Name): HOLIGENIX HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4014 OPHIE DR NE
MARIETTA GA
30066-2330
US

IV. Provider business mailing address

4014 OPHIE DR NE
MARIETTA GA
30066-2330
US

V. Phone/Fax

Practice location:
  • Phone: 888-857-8667
  • Fax:
Mailing address:
  • Phone: 888-857-8667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YINESSA NICOLE DAVIS-CACAPIT
Title or Position: OWNER
Credential: RN
Phone: 601-480-4002