Provider Demographics
| NPI: | 1184334567 |
|---|---|
| Name: | ATLANTA HEALTHCARE, LLC |
| Entity type: | Organization |
| Organization Name: | ATLANTA HEALTHCARE, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MONIQUE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | COLLINS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MBA |
| Authorized Official - Phone: | 470-541-2101 |
| Mailing Address - Street 1: | 600 HOUZE WAY STE D5 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ROSWELL |
| Mailing Address - State: | GA |
| Mailing Address - Zip Code: | 30076-1433 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 470-541-2101 |
| Mailing Address - Fax: | 404-907-1277 |
| Practice Address - Street 1: | 600 HOUZE WAY STE D5 |
| Practice Address - Street 2: | |
| Practice Address - City: | ROSWELL |
| Practice Address - State: | GA |
| Practice Address - Zip Code: | 30076-1433 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 470-541-2101 |
| Practice Address - Fax: | 404-907-1277 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-11-28 |
| Last Update Date: | 2022-11-28 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
| No | 163WP0000X | Nursing Service Providers | Registered Nurse | Pain Management | Group - Multi-Specialty |
| No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |
| No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
| No | 164X00000X | Nursing Service Providers | Licensed Vocational Nurse | Group - Multi-Specialty | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 207QG0300X | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | Group - Single Specialty |
| No | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access | Group - Single Specialty |
| No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | ||
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 372600000X | Nursing Service Related Providers | Adult Companion | Group - Multi-Specialty | |
| No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |
| No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
| No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Multi-Specialty |