Provider Demographics
NPI:1003699315
Name:HUNTER RODGERS CORPORATION
Entity Type:Organization
Organization Name:HUNTER RODGERS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERNELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:THACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-210-2471
Mailing Address - Street 1:3300 WINDFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4867
Mailing Address - Country:US
Mailing Address - Phone:470-210-2471
Mailing Address - Fax:470-648-4756
Practice Address - Street 1:3235 SATELLITE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8688
Practice Address - Country:US
Practice Address - Phone:470-210-0471
Practice Address - Fax:470-648-4756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities