Provider Demographics
NPI:1003105479
Name:MRS. HARPER'S HOUSE, LLC
Entity Type:Organization
Organization Name:MRS. HARPER'S HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATTALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-278-9028
Mailing Address - Street 1:102 VERANDA CHASE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7157
Mailing Address - Country:US
Mailing Address - Phone:678-278-9028
Mailing Address - Fax:
Practice Address - Street 1:102 VERANDA CHASE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7157
Practice Address - Country:US
Practice Address - Phone:678-278-9028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility