Provider Demographics
NPI:1750804969
Name:HEALTH AUTHORITY LLC
Entity type:Organization
Organization Name:HEALTH AUTHORITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-284-1255
Mailing Address - Street 1:2293 CANDLER RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-6403
Mailing Address - Country:US
Mailing Address - Phone:404-284-1255
Mailing Address - Fax:404-284-0125
Practice Address - Street 1:2293 CANDLER RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-6403
Practice Address - Country:US
Practice Address - Phone:404-284-1255
Practice Address - Fax:404-284-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1938111N00000X
GA101149164W00000X
GA38742207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty