Healthcare Provider Details

I. General information

NPI: 1699508564
Provider Name (Legal Business Name): BLUARK ADHC SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2024
Last Update Date: 03/08/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 ESTELLE ST
WRENS GA
30833-1125
US

IV. Provider business mailing address

206 ESTELLE ST
WRENS GA
30833-1125
US

V. Phone/Fax

Practice location:
  • Phone: 706-250-4648
  • Fax: 877-447-7790
Mailing address:
  • Phone: 706-250-4648
  • Fax: 877-447-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHEMEKA DARLENE JOHNSON
Title or Position: REGISTERED NURSE/DIRECTOR
Credential: RN
Phone: 706-250-4648