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General NPI Number Information
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NPI Number | 1043121965
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Entity Type | Organization
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Legal Business Name | KATHY & IRVIN'S HEART OF CARE, LLC
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 122 N AVONDALE RD STE 245
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City | AVONDALE ESTATES
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State | GA
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Zip | 30002-1380
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Country | US
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Telephone | 678-824-6831
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Fax | 678-824-6833
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Provider Business Mailing Address
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Address Line | 122 N AVONDALE RD STE 245
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City | AVONDALE ESTATES
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State | GA
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Zip | 30002-1380
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Country | US
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Telephone | 678-824-6831
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Fax | 678-824-6833
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Authorized Official
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Title or Position | OWNER
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Name | GRAVEZANDRA MATHURIN
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Credential |
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Telephone | 678-824-6831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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