# WALLYMANG HOMECARE AND STAFFING AGENCY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wallymang Homecare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316831472
- **Authorized official:** FATOUMATTA MINTEH CNA (OWNER)
- **Authorized official phone:** (678) 758-0116

## Contact information

- **Practice address:** 3070 CAMELLIA TRL, AUSTELL, GA 30106-2678
- **Practice address phone:** (678) 758-0116
- **Mailing address:** 3070 CAMELLIA TRL, AUSTELL, GA 30106-2678
- **Mailing address phone:** (678) 758-0116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174200000X | Meals Provider | — | NULL | — |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 385H00000X | Respite Care | — | NULL | — |
| 385HR2055X | Child Mental Illness Respite Care | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |
| 385HR2065X | Child Physical Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 06/04/2025
- **Last updated:** 06/04/2025