# CCENO HOME HEALTHCARE SVCS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174899462
- **Authorized official:** MR. NDUBUISI GODWIN OCHUBA B.SC; MBA (PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (770) 693-9465

## Contact information

- **Practice address:** 5745 WENDY BAGWELL PKWY, SUITE 1, HIRAM, GA 30141-2805
- **Practice address phone:** (770) 693-9465
- **Practice address fax:** (877) 832-2127
- **Mailing address:** PO BOX 54, POWDER SPRINGS, GA 30127-0054
- **Mailing address phone:** (770) 693-9465
- **Mailing address fax:** (877) 832-2127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 110R0673 | GA | Yes |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 03/30/2012