Healthcare Provider Details

I. General information

NPI: 1730990458
Provider Name (Legal Business Name): IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONFERENCE CENTER, 20 F ST NW 7TH FLOOR
DISTRICT OF COLUMBIA DC
20001
US

IV. Provider business mailing address

3296 HIGHPOINT CT
SNELLVILLE GA
30078-7401
US

V. Phone/Fax

Practice location:
  • Phone: 201-361-1431
  • Fax: 201-482-2893
Mailing address:
  • Phone: 201-361-1431
  • Fax: 201-482-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHARON A PEART
Title or Position: DIRECTOR
Credential:
Phone: 201-361-1431