Organization Active NPI

Healthy Goals Homecare LLC

  • In Home Supportive Care Agency
  • East Point, GA
National Provider Identifier
1689472508
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HEALTHY GOALS HOMECARE LLC
Practice address
4002 Crest Ridge Dr
East Point, GA 30344-8123
Phone
(248) 804-7303
Fax
(404) 885-8315
NPI assigned
Mar 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Kandasha GlennNPI 1437012333
Title
Administrator
Phone
(248) 804-7303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4002 Crest Ridge Dr
East Point, GA 30344-8123

Mailing address

4002 Crest Ridge Dr
East Point, GA 30344-8123
Phone (248) 804-7303

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1689472508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 CREST RIDGE DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303448123",
            "telephone_number": "248-804-7303",
            "fax_number": "404-885-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 CREST RIDGE DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303448123",
            "telephone_number": "248-804-7303",
            "fax_number": "404-885-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY GOALS HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "KANDASHA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-804-7303"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.