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General NPI Number Information
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NPI Number | 1285430462
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Entity Type | Organization
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Legal Business Name | CAREGAP HOME HEALTH
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2164 NORTHERN OAK DR
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City | BRASELTON
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State | GA
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Zip | 30517-6064
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Country | US
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Telephone | 404-618-3424
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Fax | 404-618-3428
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Provider Business Mailing Address
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Address Line | 2164 NORTHERN OAK DR
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City | BRASELTON
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State | GA
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Zip | 30517-6064
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Country | US
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Telephone | 404-618-3424
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Fax | 404-618-3428
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRYSTAL NKEM IKEMBA-MADU
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Credential | PHARMD.
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Telephone | 404-618-3424
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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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