Amicasa Home Care Corporation

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

075-R-0801 Issued in GA

Legal business name

AMICASA HOME CARE CORPORATION

Doing business as

Amicasa Home Care and Hospice

Practice address

157 Burke St
Suite 119
Stockbridge, GA 30281-3433

Phone

(404) 537-1960

NPI assigned

Dec 16, 2014

Last updated

Jan 5, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

AMICASA HOME CARE CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evelyn Afuluenu Azike

Title

Ceo-Administrator

Phone

(404) 537-1960

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Amicasa Home Care and Hospice Doing business as

Tax ID family

Amicasa Home Care Corporation2 organizations share this tax ID, including this one

Part of

Amicasa Home Care Corporation

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Amicasa Home Care Corporation

  dba Amicasa Home Care and Hospice

  • Community Based Hospice Care Agency
  • Stockbridge, GA
  • NPI 1396065777
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1174921639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 BURKE ST",
            "address_2": "SUITE 119",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813433",
            "telephone_number": "404-537-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 BURKE ST",
            "address_2": "SUITE 119",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813433",
            "telephone_number": "404-537-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMICASA HOME CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMICASA HOME CARE CORPORATION",
        "enumeration_date": "2014-12-16",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "AZIKE",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "AFULUENU",
        "authorized_official_title_or_position": "CEO-ADMINISTRATOR",
        "authorized_official_telephone_number": "404-537-1960"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "075-R-0801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CCSP",
            "identifier": "003110469B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003110469A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE JOINT COMMISSION",
            "identifier": "565352",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID SOURCE",
            "identifier": "003110469C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amicasa Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.