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General NPI Number Information
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NPI Number | 1164609921
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Entity Type | Organization
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Legal Business Name | MCPHERSON HEALTH AND REHABILITATION
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 1254 CONCORD RD SE STE 204
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City | SMYRNA
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State | GA
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Zip | 30080-4371
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Country | US
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Telephone | 678-842-0604
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 HERITAGE LAKES DR SW
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City | MABLETON
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State | GA
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Zip | 30126-1248
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Country | US
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Telephone | 678-933-3528
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Fax | 186-628-1862
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. KIM MCPHERSON GREENE
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Credential | RN, EDD
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Telephone | 678-842-0604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 120106
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License Number State | GA
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