Access Home Care, LLC

Key facts

NPI

1831674563

Entity type

Organization (NPI type 2)

Primary specialty

In Home Supportive Care Agency 253Z00000X

Legal business name

ACCESS HOME CARE, LLC

Practice address

6200 Memorial Dr Ste I
Stone Mountain, GA 30083-2849

Phone

(207) 312-8676

Fax

(404) 393-6227

NPI assigned

Sep 28, 2018

Organization subpart

No

Authorized official

Name

Mr. Mohamed Jama

Title

Adminstrator

Phone

(207) 312-8676

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2018.

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538092800000",
    "number": "1831674563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 831113",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300830019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 MEMORIAL DR STE I",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832849",
            "telephone_number": "207-312-8676",
            "fax_number": "404-393-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A",
        "authorized_official_last_name": "JAMA",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "207-312-8676",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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