Organization
AMICASA HOME CARE CORPORATION
Active
Parent organization
AMICASA HOME CARE CORPORATION
Other names
Amicasa Home Care and Hospice
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMICASA HOME CARE CORPORATION
Authorized official
EVELYN AFULUENU AZIKE (CEO-ADMINISTRATOR)
(404) 537-1960
Entity
Organization
Contact information
Practice address
157 BURKE ST, SUITE 119, STOCKBRIDGE, GA 30281-3433
(404) 537-1960
Mailing address
157 BURKE ST, SUITE 119, STOCKBRIDGE, GA 30281-3433
(404) 537-1960
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
075-R-0801
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110469A
—
GA
01
—
003110469B
MEDICAID CCSP
GA
01
—
003110469C
MEDICAID SOURCE
GA
01
—
565352
THE JOINT COMMISSION
GA
Enumeration date
12/16/2014
Last updated
01/05/2016
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