Provider Demographics
NPI:1942649215
Name:PER DIEM HEALTHCARE, INC.
Entity Type:Organization
Organization Name:PER DIEM HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-278-9353
Mailing Address - Street 1:2709 TREE MOUNTAIN PKWY
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-6774
Mailing Address - Country:US
Mailing Address - Phone:678-278-9353
Mailing Address - Fax:
Practice Address - Street 1:2709 TREE MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-6774
Practice Address - Country:US
Practice Address - Phone:678-278-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine