Provider Demographics
NPI:1770648131
Name:HARPERS PERSONAL CARE HOME, INC.
Entity Type:Organization
Organization Name:HARPERS PERSONAL CARE HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-678-6070
Mailing Address - Street 1:186 BOOTLEGGER LN E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30673-5364
Mailing Address - Country:US
Mailing Address - Phone:706-678-6070
Mailing Address - Fax:706-678-6071
Practice Address - Street 1:186 BOOTLEGGER LN E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:GA
Practice Address - Zip Code:30673-5364
Practice Address - Country:US
Practice Address - Phone:706-678-6070
Practice Address - Fax:706-678-6071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000850979BMedicaid
GA000850979AMedicaid