# MAGENTA BREEZE HOME, INC.

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

## Provider details

- **NPI number:** 1407194723
- **Authorized official:** MRS. LYNETTE TARA VICK (OWNER)
- **Authorized official phone:** (678) 526-9152

## Contact information

- **Practice address:** 776 KILKENNY CIR, LITHONIA, GA 30058-9026
- **Practice address phone:** (678) 526-9152
- **Mailing address:** 776 KILKENNY CIR, LITHONIA, GA 30058-9026
- **Mailing address phone:** (678) 526-9152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 044-01-493-1 | GA | Yes |

## Other

- **Enumeration date:** 01/21/2013
- **Last updated:** 01/21/2013