Healthcare Provider Details

I. General information

NPI: 1053162081
Provider Name (Legal Business Name): BRIDGEPOINT HOMECARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6829 DANFORTH WAY
STONE MOUNTAIN GA
30087-6370
US

IV. Provider business mailing address

6829 DANFORTH WAY
STONE MOUNTAIN GA
30087-6370
US

V. Phone/Fax

Practice location:
  • Phone: 404-414-5696
  • Fax:
Mailing address:
  • Phone: 404-414-5696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN MCINTOSH
Title or Position: OWNER
Credential:
Phone: 404-414-5696