Provider Demographics
NPI:1295014686
Name:PETERS HOME HEALTH GROUP, LLC
Entity type:Organization
Organization Name:PETERS HOME HEALTH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-385-0300
Mailing Address - Street 1:222 ROUTE 59 STE 302
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5208
Mailing Address - Country:US
Mailing Address - Phone:770-385-0300
Mailing Address - Fax:404-419-6779
Practice Address - Street 1:7209 TURNER LAKE RD NW
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2067
Practice Address - Country:US
Practice Address - Phone:770-385-0300
Practice Address - Fax:404-419-6779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA107R0003253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care