Provider Demographics
NPI:1659018000
Name:ATIA HEALTHCARE PROFESSIONALS
Entity Type:Organization
Organization Name:ATIA HEALTHCARE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMELETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-346-1920
Mailing Address - Street 1:113 SITTON CIR
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-4500
Mailing Address - Country:US
Mailing Address - Phone:256-346-1920
Mailing Address - Fax:
Practice Address - Street 1:105 COOSA PINES DR
Practice Address - Street 2:
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044-1303
Practice Address - Country:US
Practice Address - Phone:256-346-1920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home