MEDICARE: ENTOUCH HOME CARE SERVICES OF 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1639755333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENTOUCH HOME CARE SERVICES OF ATLANTA, LLC

Provider Business Mailing Address
First Line	:	3343 PEACHTREE RD NE STE 145-560
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1085
Country	:	US
Telephone Number	:	678-915-2273
Fax Number	:	678-915-2283

Provider Business Practice Location Address
First Line	:	1350 CASCADE FALLS DR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-3669
Country	:	US
Telephone Number	:	678-915-2273
Fax Number	:	678-915-2283

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MS. TIKEAH GRIGSBY
Credential	:
Telephone Number	:	678-915-2273

Provider Enumeration Date	:	03/23/2021
Last Update Date	:	03/23/2021

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