Provider Demographics
NPI:1972388718
Name:IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
Entity Type:Organization
Organization Name:IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PEART
Authorized Official - Suffix:
Authorized Official - Credentials:PAS
Authorized Official - Phone:719-517-6905
Mailing Address - Street 1:3296 HIGHPOINT CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-7401
Mailing Address - Country:US
Mailing Address - Phone:719-517-6905
Mailing Address - Fax:
Practice Address - Street 1:3296 HIGHPOINT CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7401
Practice Address - Country:US
Practice Address - Phone:719-517-6905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, PediatricGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty