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General NPI Number Information
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NPI Number | 1003105479
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Entity Type | Organization
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Legal Business Name | MRS. HARPER'S HOUSE, LLC
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 102 VERANDA CHASE DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7157
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Country | US
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Telephone | 678-278-9028
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Fax |
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Provider Business Mailing Address
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Address Line | 102 VERANDA CHASE DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7157
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Country | US
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Telephone | 678-278-9028
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. NATTALIE DAVIS-RUSH
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Credential |
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Telephone | 678-278-9028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | GA
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