# DIVERSIFIED PERSONAL HOME CARE

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

## Provider details

- **NPI number:** 1760924278
- **Authorized official:** ADESOLA OSILAJA (OWNER/CEO)
- **Authorized official phone:** (404) 993-1270

## Contact information

- **Practice address:** 145 MCINTOSH PLACE DR, FAYETTEVILLE, GA 30214-7318
- **Practice address phone:** (404) 993-1270
- **Mailing address:** 145 MCINTOSH PLACE DR, FAYETTEVILLE, GA 30214-7318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 311500000X | Alzheimer Center (Dementia Center) | 056-R-1338 | GA | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | 056-R-1338 | GA | — |

## Other

- **Enumeration date:** 11/15/2016
- **Last updated:** 03/28/2017