Provider Demographics
NPI:1083058424
Name:AT HOME PARTNERS
Entity Type:Organization
Organization Name:AT HOME PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NYARKO
Authorized Official - Middle Name:O
Authorized Official - Last Name:MUNGIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-698-1732
Mailing Address - Street 1:PO BOX 16692
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30321-0692
Mailing Address - Country:US
Mailing Address - Phone:404-698-1732
Mailing Address - Fax:404-698-1732
Practice Address - Street 1:4725 WALTON XING SW
Practice Address - Street 2:5309
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-6279
Practice Address - Country:US
Practice Address - Phone:404-698-1732
Practice Address - Fax:404-698-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN220068163W00000X
GALPN044213164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty