=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669341442
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOYHA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2025
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7284 WOODLAND CIR
-----------------------------------------------------
City | RIVERDALE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30274-3321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-667-0683
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7284 WOODLAND CIR
-----------------------------------------------------
City | RIVERDALE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30274-3321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-667-0683
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MS. LATRINA HOWELL-SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-667-0683
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 376K00000X
-----------------------------------------------------
Taxonomy Name | Nurse's Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------