Diversified Personal Home Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVERSIFIED PERSONAL HOME CARE

Practice address

145 McIntosh Place Dr
Fayetteville, GA 30214-7318

Phone

(404) 993-1270

NPI assigned

Nov 15, 2016

Last updated

Mar 28, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adesola Osilaja

Title

Owner/Ceo

Phone

(404) 993-1270

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1760924278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MCINTOSH PLACE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MCINTOSH PLACE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147318",
            "telephone_number": "404-993-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED PERSONAL HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "OSILAJA",
        "authorized_official_first_name": "ADESOLA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "404-993-1270"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "GA",
            "license": "056-R-1338",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "GA",
            "license": "056-R-1338",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH CARE",
            "identifier": "14028509",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Fayetteville, GA
• Providers in Fayetteville, 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 Mar 28, 2017; 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.