Healthcare Provider Details

I. General information

NPI: 1043311715
Provider Name (Legal Business Name): SHEPHERD CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1426
US

IV. Provider business mailing address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1426
US

V. Phone/Fax

Practice location:
  • Phone: 404-367-1383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: SARAH MORRISON
Title or Position: CEO
Credential:
Phone: 404-352-2020