MEDICARE: NURTURA HOME CARE SERVICES 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	:	1346179678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURTURA HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	255 HIGH ST APT 235
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30346-1102
Country	:	US
Telephone Number	:	954-839-4935
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 PEACHTREE ST NE STE 1000
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30361-3542
Country	:	US
Telephone Number	:	786-288-9669
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KENECIA LII
Credential	:
Telephone Number	:	954-839-4935

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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