Provider Demographics
NPI:1518497254
Name:VISITING NURSE HEALTH SYSTEM
Entity Type:Organization
Organization Name:VISITING NURSE HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-215-6000
Mailing Address - Street 1:5775 GLENRIDGE DR STE E200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-7294
Mailing Address - Country:US
Mailing Address - Phone:404-222-2417
Mailing Address - Fax:404-527-8041
Practice Address - Street 1:5775 GLENRIDGE DR STE E200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-7294
Practice Address - Country:US
Practice Address - Phone:404-222-2417
Practice Address - Fax:404-527-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003184616AMedicaid
GA003212521BMedicaid
GA003156738AMedicaid
GA003212521AMedicaid