Healthcare Provider Details

I. General information

NPI: 1811709538
Provider Name (Legal Business Name): MNR HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2795 MAIN ST W STE 26A
SNELLVILLE GA
30078-3075
US

IV. Provider business mailing address

PO BOX 390551
SNELLVILLE GA
30039-0010
US

V. Phone/Fax

Practice location:
  • Phone: 470-909-7318
  • Fax: 770-676-7087
Mailing address:
  • Phone: 470-909-7318
  • Fax: 770-676-7087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE RICHARDSON
Title or Position: CEO
Credential:
Phone: 678-448-2853