=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649880485
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASSUMPTA HOMECARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2020
-----------------------------------------------------
Last Update Date | 08/06/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 765 WELFORD RD
-----------------------------------------------------
City | SUWANEE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30024-3129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-568-9321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2133 LAWRENCEVILLE SUWANEE RD STE 12-319
-----------------------------------------------------
City | SUWANEE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30024-2648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-906-3013
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. ADETORO M TALABI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 770-906-3013
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------