Organization
BREAD OF LIFE HOME HEALTH SVCS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GODWIN A ANANABA (CEO)
(770) 317-5259
Entity
Organization
Contact information
Practice address
2001 MARTIN LUTHER KING JR DR SW, SUITE 409, ATLANTA, GA 30310-1101
(404) 564-6486
(404) 564-6487
Mailing address
2001 MARTIN LUTHER KING JR DR SW, SUITE 409, ATLANTA, GA 30310-1101
(404) 564-6486
(404) 564-6487
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
GA
251E00000X
Home Health Agency
—
GA
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
253Z00000X
In Home Supportive Care Agency
—
GA
261QC1500X
Community Health Clinic/Center
—
GA
Other
Enumeration date
03/24/2014
Last updated
03/24/2014
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