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General NPI Number Information
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NPI Number | 1053122911
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Entity Type | Organization
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Legal Business Name | IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
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Dates
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Enumeration Date | 01/18/2025
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 4449 EASTON WAY
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City | COLUMBUS
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State | OH
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Zip | 43219-6093
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Country | US
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Telephone | 201-361-1431
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Fax | 201-482-2893
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Provider Business Mailing Address
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Address Line | 3296 HIGHPOINT CT
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City | SNELLVILLE
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State | GA
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Zip | 30078-7401
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Country | US
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Telephone | 201-361-1431
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Fax | 201-482-2893
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Authorized Official
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Title or Position | DIRECTOR
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Name | SHARON A PEART
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Credential |
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Telephone | 201-361-1431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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