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General NPI Number Information
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NPI Number | 1679942676
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Entity Type | Organization
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Legal Business Name | REDEMPTION HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 09/20/2015
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 6705 LAKEFIELD FORREST DR
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City | RIVERDALE
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State | GA
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Zip | 30296-1976
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Country | US
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Telephone | 404-917-6746
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Fax |
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Provider Business Mailing Address
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Address Line | 6705 LAKEFIELD FORREST DR
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City | RIVERDALE
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State | GA
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Zip | 30296-1976
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Country | US
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Telephone | 404-917-6746
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Fax |
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Authorized Official
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Title or Position | RNBSN
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Name | MS. MATILDA ADAKU ADDO
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Credential | RN
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Telephone | 404-542-6111
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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 | 031-R-1465
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | GA
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