Healthcare Provider Details

I. General information

NPI: 1710799747
Provider Name (Legal Business Name): IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WALL ST
NEW YORK NY
10005-2101
US

IV. Provider business mailing address

3296 HIGHPOINT CT
SNELLVILLE GA
30078-7401
US

V. Phone/Fax

Practice location:
  • Phone: 201-361-1431
  • Fax: 201-482-2893
Mailing address:
  • Phone: 201-361-1431
  • Fax: 201-482-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SHARON PEART
Title or Position: DIRECTOR
Credential:
Phone: 201-361-1431