Healthcare Provider Details

I. General information

NPI: 1093681454
Provider Name (Legal Business Name): ALISA HOMECARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE STE 200
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

2248 BROADWAY # 1558
NEW YORK NY
10024-5805
US

V. Phone/Fax

Practice location:
  • Phone: 470-524-0884
  • Fax:
Mailing address:
  • Phone: 470-524-0884
  • Fax: 518-413-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TATIANNA S PARKER
Title or Position: CEO
Credential:
Phone: 470-524-0884