Organization
AMPLIFYED HOLDINGS CORP
Active
Other names
Amplifyed Health
Organization subpart
No
Provider details
NPI number
Authorized official
TACQUORA LASHAE MIXON CMA, CNA (MANAGER)
(404) 998-6903
Entity
Organization
Contact information
Practice address
2882 CHURCH ST, EAST POINT, GA 30344-3254
(404) 692-8860
Mailing address
2882 CHURCH ST, EAST POINT, GA 30344-3254
(404) 692-8860
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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