Private Home Assistance of Georgia, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

033-R-0085 Issued in GA

Legal business name

PRIVATE HOME ASSISTANCE OF GEORGIA, INC.

Practice address

707 Whitlock Ave SW
Suite F-3
Marietta, GA 30064-3000

Phone

(678) 355-6000

Fax

(678) 355-6077

NPI assigned

Nov 6, 2006

Last updated

Apr 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Randall Brown, NHA

Title

Administrator

Phone

(678) 355-6000

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1689743833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 WHITLOCK AVE SW",
            "address_2": "SUITE F-3",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643000",
            "telephone_number": "678-355-6000",
            "fax_number": "678-355-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 WHITLOCK AVE SW",
            "address_2": "SUITE F-3",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643000",
            "telephone_number": "678-355-6000",
            "fax_number": "678-355-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE HOME ASSISTANCE OF GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-355-6000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "033-R-0085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530581025A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530581025B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Marietta, GA
• Providers in Marietta, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.