Healthcare Provider Details

I. General information

NPI: 1518386721
Provider Name (Legal Business Name): HARBEK PRIVATE HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 CREEK TRCE E
HIRAM GA
30141-3342
US

IV. Provider business mailing address

3249 CREEK TRCE E
HIRAM GA
30141-3342
US

V. Phone/Fax

Practice location:
  • Phone: 678-491-5049
  • Fax: 678-567-1154
Mailing address:
  • Phone: 678-491-5049
  • Fax: 678-567-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number033-R-1134
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number033-R-1134
License Number StateGA

VIII. Authorized Official

Name: CHINYERE HELEN ALIOHA
Title or Position: ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 678-491-5049