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General NPI Number Information
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NPI Number | 1003348707
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Entity Type | Organization
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Legal Business Name | JENESYS HOME CARE ATLANTA
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 3464 ROXBORO RD NE UNIT 1110
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City | ATLANTA
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State | GA
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Zip | 30326-1317
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Country | US
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Telephone | 757-419-6153
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Fax | 757-420-0599
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Provider Business Mailing Address
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Address Line | 1403 GREENBRIER PKWY STE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2876
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Country | US
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Telephone | 757-420-0566
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHANTE HALL
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Credential |
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Telephone | 757-420-0566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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