Healthcare Provider Details

I. General information

NPI: 1467107482
Provider Name (Legal Business Name): AMBASSADOR LOVING CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 LOST LAKES DR
POWDER SPRINGS GA
30127-6036
US

IV. Provider business mailing address

2716 LOST LAKES DR
POWDER SPRINGS GA
30127-6036
US

V. Phone/Fax

Practice location:
  • Phone: 678-643-1188
  • Fax: 678-239-4373
Mailing address:
  • Phone: 678-643-1188
  • Fax: 678-239-4373

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: PATIENCE N OGBUEFI
Title or Position: ADMINISTRATOR/REGISTERED NURSE
Credential:
Phone: 678-643-1188