Magenta Breeze Home, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

044-01-493-1 Issued in GA

Legal business name

MAGENTA BREEZE HOME, INC.

Practice address

776 Kilkenny Cir
Lithonia, GA 30058-9026

Phone

(678) 526-9152

NPI assigned

Jan 21, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Lynette Tara Vick

Title

Owner

Phone

(678) 526-9152

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358726400000",
    "number": "1407194723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 KILKENNY CIR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300589026",
            "telephone_number": "678-526-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 KILKENNY CIR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300589026",
            "telephone_number": "678-526-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGENTA BREEZE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-21",
        "last_updated": "2013-01-21",
        "status": "A",
        "authorized_official_last_name": "VICK",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_middle_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-526-9152",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "044-01-493-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA",
            "identifier": "044-01-493-1",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Lithonia, GA
• Providers in Lithonia, 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 21, 2013; 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.