Provider Demographics
NPI:1417609835
Name:HOME OF THE HEROES
Entity Type:Organization
Organization Name:HOME OF THE HEROES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARKEES
Authorized Official - Middle Name:DEONTA
Authorized Official - Last Name:GRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-403-9834
Mailing Address - Street 1:2055 GEES MILL RD NE STE 324
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1364
Mailing Address - Country:US
Mailing Address - Phone:470-403-9834
Mailing Address - Fax:
Practice Address - Street 1:2055 GEES MILL RD NE STE 324
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1364
Practice Address - Country:US
Practice Address - Phone:470-403-9834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health