=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316211675
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZENUX HEALTHCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2012
-----------------------------------------------------
Last Update Date | 03/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2310 PARKLAKE DR NE STE 186
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30345-2915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-679-5218
-----------------------------------------------------
Fax | 770-679-5219
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2310 PARKLAKE DR NE STE 186
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30345-2915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-679-5218
-----------------------------------------------------
Fax | 770-679-5219
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | MR. FOLABI LADIPO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 770-679-5218
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 122-R-1013
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------