Organization
GAIA HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWIZERA RICHARD RN, BSN (CEO/ADMINISTRATOR)
(404) 944-6826
Entity
Organization
Contact information
Practice address
4749 BANNER ELK DR, STONE MOUNTAIN, GA 30083-4916
(404) 944-6826
Mailing address
4749 BANNER ELK DR, STONE MOUNTAIN, GA 30083-4916
(404) 944-6826
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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