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General NPI Number Information
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NPI Number | 1487593919
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Entity Type | Organization
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Legal Business Name | IVANNA HOMECARE
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 66 LONGWOOD CT
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City | DALLAS
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State | GA
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Zip | 30132-1146
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Country | US
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Telephone | 470-794-7254
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Fax | 470-794-7254
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | DALLAS
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State | GA
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Zip | 30132-0002
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Country | US
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Telephone | 404-287-7713
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MERCY EKEUWA
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Credential |
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Telephone | 470-794-7254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 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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Taxonomy #3
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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