Provider Demographics
NPI:1619523925
Name:TARR PERSONAL CARE HOME LLC.
Entity Type:Organization
Organization Name:TARR PERSONAL CARE HOME LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARBEA
Authorized Official - Middle Name:TARR
Authorized Official - Last Name:NUAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-454-7414
Mailing Address - Street 1:628 RIVER MIST DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-5789
Mailing Address - Country:US
Mailing Address - Phone:404-454-7414
Mailing Address - Fax:470-317-5901
Practice Address - Street 1:1180 MUNDYS MILL RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-6038
Practice Address - Country:US
Practice Address - Phone:404-454-7414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness