Specialized Healthcare Services Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

033-R-1448 Issued in GA

Legal business name

SPECIALIZED HEALTHCARE SERVICES INC

Practice address

2920 Tobacco Road, Suit a
Hephzibah, GA 30815

Phone

(770) 365-0578

NPI assigned

Aug 31, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Johnette Divers

Title

Contracts Administrator

Phone

(404) 604-5691

Specialties & licenses 1

Addresses

Other names 1

• Specialized Healthcare Services LLC Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679091458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 TOBACCO RD STE A",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308159012",
            "telephone_number": "770-365-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 TOBACCO ROAD, SUIT A",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "30815",
            "telephone_number": "770-365-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DIVERS",
        "authorized_official_first_name": "JOHNETTE",
        "authorized_official_title_or_position": "CONTRACTS ADMINISTRATOR",
        "authorized_official_telephone_number": "404-604-5691",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "033-R-1448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialized Healthcare Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.