Provider Demographics
NPI:1922320035
Name:RHEMA HOUSING INC
Entity Type:Organization
Organization Name:RHEMA HOUSING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-456-6232
Mailing Address - Street 1:1836 CARROLLTON VILLA RICA HWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-5192
Mailing Address - Country:US
Mailing Address - Phone:770-456-6232
Mailing Address - Fax:770-456-8707
Practice Address - Street 1:1836 CARROLLTON VILLA RICA HWY
Practice Address - Street 2:SUITE 209
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-5192
Practice Address - Country:US
Practice Address - Phone:770-456-6232
Practice Address - Fax:770-456-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00972892AMedicaid