Provider Demographics
NPI:1821704966
Name:ATLANTA HOST SERVICES
Entity Type:Organization
Organization Name:ATLANTA HOST SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:678-200-2973
Mailing Address - Street 1:1441 WOODMONT LN NW STE 2911
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2866
Mailing Address - Country:US
Mailing Address - Phone:678-515-6092
Mailing Address - Fax:
Practice Address - Street 1:2795 MAIN ST W STE 14B
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3198
Practice Address - Country:US
Practice Address - Phone:678-200-2973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty