# KANISHA ALEXANDER

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

## Provider details

- **NPI number:** 1841688017
- **Authorized official:** KANISHA MONIQUE ALEXANDER (STNA)
- **Authorized official phone:** (614) 600-0807

## Contact information

- **Practice address:** 1880 SHAMROCK DR, DECATUR, GA 30032-7011
- **Practice address phone:** (614) 600-0807
- **Mailing address:** 1880 SHAMROCK DR, DECATUR, GA 30032-7011
- **Mailing address phone:** (614) 600-0807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 501129910606 | OH | Yes |

## Other

- **Enumeration date:** 12/22/2014
- **Last updated:** 12/22/2014