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General NPI Number Information
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NPI Number | 1750255337
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Entity Type | Organization
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Legal Business Name | OPTIMUM HEALTH HOME CARE LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3340 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30326-1000
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Country | US
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Telephone | 877-380-1808
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 WHISPERWOOD TRL
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City | STONE MOUNTAIN
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State | GA
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Zip | 30088-1813
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Country | US
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Telephone | 877-380-1808
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AYAN JAMA
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Credential | LPN, OWNER
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Telephone | 612-267-7704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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