Healthcare Provider Details

I. General information

NPI: 1821158957
Provider Name (Legal Business Name): SENIOR HEALTHCARE SOLUTIONS OF ATLANTA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 GARRETT ST SE UNIT 313
ATLANTA GA
30316-6826
US

IV. Provider business mailing address

925 GARRETT ST SE UNIT 313
ATLANTA GA
30316-6826
US

V. Phone/Fax

Practice location:
  • Phone: 404-323-1807
  • Fax:
Mailing address:
  • Phone: 404-323-1807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN158648
License Number StateGA

VIII. Authorized Official

Name: ELIZABETH L ROBINSON
Title or Position: PRINCIPAL
Credential:
Phone: 404-323-1807