Healthcare Provider Details

I. General information

NPI: 1346154044
Provider Name (Legal Business Name): HARMONY AT EAGLES LANDING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 PATRICK HENRY PKWY
MCDONOUGH GA
30253-4276
US

IV. Provider business mailing address

4423 PHEASANT RIDGE RD STE 201
ROANOKE VA
24014-5300
US

V. Phone/Fax

Practice location:
  • Phone: 770-709-5640
  • Fax:
Mailing address:
  • Phone: 540-774-7762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JASON DYNAK
Title or Position: LICENSING COORDINATOR
Credential:
Phone: 843-793-2551