Provider Demographics
NPI:1881373868
Name:CORINTHIANHOMWCARESERVICES
Entity type:Organization
Organization Name:CORINTHIANHOMWCARESERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:CORINTHIAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:CN0014212721
Authorized Official - Phone:404-353-5167
Mailing Address - Street 1:600 NORTHERN AVE APT 4206
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-2028
Mailing Address - Country:US
Mailing Address - Phone:404-353-5167
Mailing Address - Fax:
Practice Address - Street 1:600 NORTHERN AVE APT 4206
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-2028
Practice Address - Country:US
Practice Address - Phone:404-353-5167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty