MEDICARE: HEALING ARMS PRIVATE HOME CARE SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1336646991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ARMS PRIVATE HOME CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	930 GRAND RESERVE DR
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-1639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 GRAND RESERVE DR
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-1639
Country	:	US
Telephone Number	:	678-279-5811
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EDITH OBI
Credential	:
Telephone Number	:	678-279-5811

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	04/10/2018

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