MEDICARE: ELDER'S JOURNEY HOME CARE OF NORTHERN ATLANTA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1093690992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDER'S JOURNEY HOME CARE OF NORTHERN ATLANTA, LLC

Provider Business Mailing Address
First Line	:	4255 N. ARNOLD MILL ROAD
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-3017
Country	:	US
Telephone Number	:	470-307-2660
Fax Number	:	678-653-8555

Provider Business Practice Location Address
First Line	:	4255 N. ARNOLD MILL ROAD
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-3017
Country	:	US
Telephone Number	:	470-307-2660
Fax Number	:	678-653-8555

Authorized Official
Title or Position	:	OWNER
Name	:	ANN MARIE HARRISON
Credential	:	RN
Telephone Number	:	812-360-7041

Provider Enumeration Date	:	08/08/2025
Last Update Date	:	08/08/2025

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