Healthcare Provider Details

I. General information

NPI: 1497690051
Provider Name (Legal Business Name): HATHROCK HEALTHCARE NETWORK, LLC/
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PAVILION CT
MCDONOUGH GA
30253-6666
US

IV. Provider business mailing address

817 PAVILION CT
MCDONOUGH GA
30253-6666
US

V. Phone/Fax

Practice location:
  • Phone: 470-357-2974
  • Fax: 404-923-9933
Mailing address:
  • Phone: 470-357-2974
  • Fax: 404-923-9933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL E. CANTY SR.
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 470-357-2974