Organization
AMICUS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSARETIN ISIBOR (CEO)
(770) 939-0146
Entity
Organization
Contact information
Practice address
3469 LAWRENCEVILLE HWY STE 304, TUCKER, GA 30084-5890
(770) 939-0146
(770) 939-0145
Mailing address
3469 LAWRENCEVILLE HWY STE 304, TUCKER, GA 30084-5890
(770) 939-0146
(770) 939-0145
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
122-R-0514
GA
253Z00000X
In Home Supportive Care Agency
122-R-0514
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003201115A
—
GA
05
—
003201116A
—
GA
05
—
919016846C
—
GA
Enumeration date
09/29/2010
Last updated
07/10/2024
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